Medicines from the Earth

Herb Symposium

2025 Lecture Notes

MEDICINES FROM THE EARTH
HERB SYMPOSIUM, 2025

Lecture Notes

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Contents
(Click the page number to navigate to an article)

Lise Alschuler, ND, FABNO, eMBA

Unsung Herbal Heroes of Immunity ...................................................................... 1
My 7 Top Integrative Oncology Botanicals ........................................................... 7

Teresa Boardwine, RH (AHG)

Providing Mutual Herbal Aid after Helene: Formulas for Building Resilience
(Demonstration) ................................................................................................... 22
Non-Alcohol Herbal Extractions: Vinegar, Honey, Glycerin and Oils ................ 31

Lindsay Chimelski, ND, LAc, RH (AHG)

Fungi Medicine in Clinical Practice ................................................................... 37
Nootropic Mushrooms & Your Mind: Ancient Wisdom Meets Exciting New
Research .............................................................................................................. 57

Sam Coffman, L.Ac, W-EMT, RH(AHG), Best-selling Author

Disaster Herbalism .............................................................................................. 84
Advanced Wound and Infection Management Concepts (Demonstration) .......... 90

Tesia Love, Clinical Ayurvedic Practitioner

Matters of the Heart: Herbal Support for Grief and Loss ................................. 101

Kat Maier, RH (AHG)

Cooling Remedies in Climate Change ............................................................... 111

Kenneth Proefrock, NMD

Surface Eruptions: A Primer on Skin Rashes and Botanical Medicine
Approaches to their Treatment ........................................................................... 123
Surface Eruptions: A Primer on Skin Rashes and Botanical Medicine
Approaches to their Treatment - Article............................................................. 140
 Swinging the Pendulum-Acid-Base Chemistry for Herbalists
(Demonstration).. ............................................................................................... 166
Swinging the Pendulum-Acid-Base Chemistry for Herbalists
(Demonstration) - Article.. ................................................................................. 180
The Foot–The Natural History of an Appendage.. ............................................ 199
The Foot–The Natural History of an Appendage - Article ................................ 214

Katie Stage, ND, RH (AHG), FABNG

Botanical Support for HPV and Cervical Dysplasia ......................................... 244
Intestinal Permeability: Symptoms, Controversy, and Treatment Approaches .. 258

Wendy Warner, MD, ABIHM, IFMCP

Pre-Conference Intensive: Menopause as a Neuroinflammatory and Hormonal
Event ................................................................................................................. 269
Natural Approaches to Fertility ......................................................................... 290

David Winston, RH (AHG)

Last Butt not Least – Herbal/Nutritional Proctology ........................................ 302

Panel: Insulin Resistance and Type 2 Diabetes: How to Motivate Patients to

Make Meaningful and Impactful Dietary and Lifestyle Changes
Lise Alschuler..................................................................................................... 313
Lindsay Chimelski .............................................................................................. 316
Wendy Warner .................................................................................................... 318
 2025 Medicines from the Earth Herbal Immunity - Alschuler

Disclosures
Unsung Herbal
Heroes of Immunity • Compensated occasional industry-sponsored webinars and educational presentations:
• NutraBioceuticals, Gaia, NFH, Nordic Naturals
Lise Alschuler, ND, FABNO
• Co-principal for Thrivers, LLC that runs a podcast with commercial support from:
Associate Director, Fellowship
in Integrative Medicine • Kyowa Hakko, Essential Formulas, Integrative Therapeutics
Professor of Clinical Medicine

University of Arizona | Andrew Weil

Center for Integrative Medicine

Incoming President
Sonoran University of Health
Sciences

Topics Immunity:
Innate and
• A brief review of immunity
• Focus on anti-viral immunity
Adaptive
• Focus on SARS-CoV-2
• Highlighted botanicals:
• Usnea spp.
• Spilanthes acmella
• Hemidesmus indicus
• Coptis chinensis
• Andrographis chinensis
• Echinacea spp.
• Sambucus nigra

• Not antigen-specific
• First line of defense prior
Innate Immunity Acquired (Adaptive) Immunity
to the initiation of an
adaptive immune
response against tumor or • Second line of defense
infection. • Protects against re-exposure
• Recruit Immune cells to to the same pathogens
the sites of infection
through the production of • Antigen-specific and takes
cytokines time to react
• Activates complement • Has immunological memory
cascade to id bacteria,
activate cells and promote
clearance of antibody
complexes
• Influences the adaptive
immune system. Langers I, et al. Biologics: Targets and Therapy. 2012;6:73-82

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 2025 Medicines from the Earth Herbal Immunity - Alschuler

Adaptive Immunity: B-cells and T-cells T-cell Immunity: cytokines

> Intracellular infections

> Extracellular infections

> Cell-mediated immunity

Parkin J, Cohen B. Lancet. 2001 Jun 2;357(9270):1777-89

↑Effector Function https://i.pinimg.com/originals/f7/c9/72/f7c972b7d98c

↑Memory Function 3217430daac6f3d0c40f.png
Golubovskaya V, Wu L. Cancers 2016, 8(3): 36

Prevention vs. Disease Management Prevention of viral infections:

3 components, ex. SARS-CoV-2
It is important to separate prevention support
from support for mild/moderate symptomatic 1. Block viral docking to
infection due to the role of inflammation. ACE2 receptors
2. Prevent viral entry by
Inflammation is initially a critical element of inhibiting cellular
immune activation and antiviral peptide proteases (TMPRSS2)
production. and viral replication
(papain-like protease
However, excessive inflammation (NLRP3 2, PLP2)
inflammasome activation and continued TH1 3. Increase antigen Pyroptosis: Viral
presenting cell & infection leads to
activation) generated underlies the virulence programmed cell
and complications of viral disease, so anti- gamma delta T cell death caused by DAMPs
inflammatory strategies are important once activity, INF-!, inflammatory
infection and/or symptoms are present. secretion and caspases. Causes
subsequent defensive release of
cytoplasmic
Chen I-Y, et al. Front Microbiol. 2019;10:50 NLRP3 inflammasome components
activation Inflammation

Echinacea: Anti-viral
Prevention: 1. Block viral entry Clinically studied
Level of
Mechanisms Best Evidence Evidence Citations
dosages
& Harm
Block ACE2 receptor binding: SARS-CoV-2
S-glycoprotein interacts with ACE2 receptor for Sys Rev/Meta-analysis (2019), 29
DBRPCT on URI: overall risk ratio of
1:2 tincture, 3-
7mL/day (20-50
viral entry. 0.78* (95%CI 0.68-0.88) for URI, mL/week)
however sub-group analysis of 1:5 tincture., 9- Sholto D and
Astragalus membranaceus extract has been show in rats children show RR of 0.60 (95%CI 15mL/day (60 – Cunningham R,
to decrease ACE receptor activity.1 0.51-0.69). 100mL/week) Complement
*Note: 12% reduction in risk (RR of Expressed juice of E. Ther Med.
Improves sIgA
Quercetin has been shown to bind to ACE2 and prevent (mucosal
0.78) means that @ 4 URI/year, purpurea: 6-10 ml 2019;44:18-26
viral binding in a supercomputer-based in-silico study.2 immunity);
Echinacea x 3y would prevent one URI. daily
Grade B;
DBRCT (2021), of children ages 4-12y, Cohen HA, et al.
Vitamin D3 reduces ACE2 activation3 and vit D sufficiency Echinacea spp. downreglulates assessing effect of 1.2g Echinaforce© Ped:
rare skin Arch Pediatr
proinflammator rash
is associated with reduced infection and mortality4 y cytokines esp.
(fresh E purpurea leaves and root 1:2 tincture, 1 drop/4# Adolesc Med.
tincture) compared to 150mg vit. C body weight in 2+ 2004;158:217
TNF! and IL-8
(controls) x 2 months for prevention of divided doses
URI. In the intention to treat analysis, Echinaforce©: Ogal M, Eur J
Echinacea prevented 32.5% of viral Ages 4y-12y: 30 – 50 Med Res.
1. Wang Q-Y. Zhongguo Zhong Yao Za Zhi. 2015.40(21):4245 [abstract only] respiratory tract infections, yielding OR drops daily in divided 2021;26(1):33
2. Smith M et al. ChemRxiv.2020;v4. [not peer reviewed] = 0.52 (95% CI 0.30-0.91, p= o.021). doses
3. Cui C, et al. Redox Biol. 2019;26:101295 Further, 76% fewer Echinacea-treated Ages 12+: 60 drops
4. Ilie PC, et al. Aging Clinical Exp Res. 2020;32:1195 children required antibiotics. daily in divided doses

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 2025 Medicines from the Earth Herbal Immunity - Alschuler

Prevention: 2. Inhibit viral replication Prevention: 2. Inhibit viral replication

Zinc ionophores: Chelators of zinc, increasing its transport
into the cytoplasm
Zinc potently inhibits the Zn
Dihydroquercetin1 and quercetin1 Source: onions, apples
enzymatic activity of SARS-CoV
Epigallocatechin gallate1 (EGCG) Source: tea leaves, esp. green tea
PLP2 (viral protease).
Glycyrrhizin from Glycyrrhiza glabra (licorice plant)
This inhibition results in: Zn
Inhibits SARS-CoV virus replication, adsorption and penetration of the
Reduction of viral replication virus2,3 (more potent than ribavirin, 6-azauridine, pyrazofurin,
mycophenolic acid)4
Increased interferon produced by the Samples derived from patients with SARS admitted for treatment in
cell which destroys the virus Germany (2003)
Note: elevated blood pressure and hypokalemia can occur in some
individuals after several months of (high dose*) glycyrrhizin.
Prevention/early treatment of SARS should only be needed for a short
time avoiding this potential adverse effect.
*>50g licorice/day >2 weeks
Han Y-S, et al. Biochemistry. 2005;44(30):10349. 1. Dabbagh-Bazarbachi H, et al. J Agric Food Chem. 2014;62(32):8085
Baez-Santos, YM, Antiviral Res. 2015;115:21. 2. Cinati J, et al. Lancet. 2003;361(9374):2045
Yuan L, et al. J Biol Chem. 2015;290(5):3172. 3. De Clercq, Expert Rev Anti Infect Ther. 2006;4(2):291
4. Hoever G, et al. J Med Chem. 2005;48(4):1256.

Prevention: 3. NLRP3-induced inflammation

Prevention: Inhibit viral replication & attachment
Pyroptosis: Viral infection
Virus leads to programmed cell
Triggered by stimuli during infections, tissue
damage or metabolic imbalances death caused by
inflammatory caspases.
Elderberry (Sambucus nigra): Causes release of
cytoplasmic components
Inhibits replication and viral
attachment of human coronavirus
NL63 (HCoV-NL63).

DAMPs

Weng JR, et al. Virus Res. 2019;273:197767 Inflammation

Prevention: Double-edged sword of the Prevention of COVID-19 illness:

NLRP3 inflammasome Reduce NLRP3 inflammasome activation, animal data
• In initial infection, NLRP3 inflammasome activation:1
• Triggers inflammation-associated cell death • In a juvenile mouse model of influenza A viral infection, inhibition of the NLRP3
• Activates neutrophil recruitment to the site to aid in elimination of virally infected cells inflammasome starting 3 days after infection ameliorated severe NLRP3
• However, in the case of SARS-CoV-2, excessive NLRP3 activation and its associated cytokines (esp. inflammasome-mediated lung injury without impairing viral clearance1
IL-1beta) contribute to extensive pyroptosis (inflammatory cell death from infection) and • NLRP3 inflammasome activation (and associated IL-1beta, and subsequently IL-6
accentuated inflammation leading to outcomes such as acute respiratory distress.2 and TNF!) is responsible for pneumonia and acute respiratory distress from avian
• Furthermore, in patients with severe Covid-19 symptoms, there are differences in immune responses influenza A H5N1 infection.2
leading to more inflammation:3
• Greater quantity of non-virus specific CD4+ T-cells in circulation
• NFkB activation activates pro-IL-1B transcription and its inhibition improves
survival in severe acute respiratory syndrome in coronavirus-infected mice.3
• Impaired CD4+ T cell responsivity and fewer resident T cells (which are more virally specific)
• Decreased IFN-! so greater viral load
• Neutralizing IgG antibodies are significantly higher with consequent immune impairment
1. Coates BM, et al. Front Immunol. 2017;8:782
1. Zhao C and Zhao W. Front Immunol. 18 Feb 2020
2. Chen YJ, et al. Am J Pathol. 2018;188(4):1031
2. Chen I-Y, et al. Front Microbiol. 2019;10:50.
3. DeDeigo ML, et al. J Virol. 2014;88(2):913
3. Oja A, et al. Eur J Immunol. 2020;50(12):1988

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 2025 Medicines from the Earth Herbal Immunity - Alschuler

Inflammation, Disease Severity & Immunomodulation Prevention: 3. Immunoinflammation

• Severe disease is characterized by decreased CD4+ TH1-cell production of IFN-! and IL-4: • Vitamin D induces cathelicidin, an antiviral
• IFN-! downregulates cell surface expression of ACE2 and inhibits SARS-CoV-2 replication peptide secreted by immune cells and respiratory
• IL-4 antagonizes TH1 and TH17 responses thereby supporting immune suppressive Treg cells epithelial cells
(thus quelling tissue-damaging inflammation) • Vit. D has immune-modulating actions:
• In severely ill individuals, SARS-CoV-2 specific CD4+ TH1 cells do not produce IL-4, thus impairing the • Increases macrophage (APC) activation
ability to prevent a hyperimmune response and Covid-19 cytokine storm.
• Inhibits APC production of IL-1a, IL-1b, TNF-a
• Also in severely ill individuals, delayed and insufficient CD4+ T-cell control of viral loads
• Increases IL-10 (immunosuppressive)
along with decreased innate immune function (common in the elderly) lead to more severe
• Up and down-regulation of NFkB
symptoms.
• Failure of a balanced participation of B- and T-cells leads to alveolar epithelial and • Note, however, that high vit D can potentiate CD4+
endothelium inflammation causing vascular leakage. This leads to increased immune cell TH1 cell responses – supporting an inflammatory
infiltration of non-SARS-CoV-2-specific immune cells and further pulmonary edema. response in the lungs

Altmann & Boyton, Sci Immunol. 2020

Cannell JJ, et al. Epidemiol Infect. 2006;134(6):1129.
Oja A, et al. Eur J Immunol. 2020;50(12):1988 Hughes DA and Norton R. Clin Exp Immunol. 2009;158(1):20.

Prevention of inflammation associated with Decrease symptoms/severity of infections

viral infection Mechanisms Best Evidence
Clinically
studied
Level of
Evidence & Citations
dosages Harm

Meta-analysis (2019), 4 RCT, n=180 found that

Level of elderberry reduces duration and severity of URIs, Grade A;
Clinically especially influenza (regardless of vaccination Syrup [1 uncooked
Mechanisms Best Evidence Evidence Citations Hawkins J,
studied dosages status) with weighted effect size of 2.074 (SE: 0.383; tsp/5mL = 1.9g fresh berries
& Harm 95% CI: 1.323–2.824; P = <.001), but did not reduce stnd. liquid are poisonous
Complemen
symptoms caused by the common cold [weighted t Ther Med.
standardized to 40%- extr. 2:1]: (d/t
Sambucus Anti-viral; effect size of 0.662 (SE: 0.387; 95% CI: -0.096 - 1.421; 2019;42:361.
70% polysaccharides cyanogenic
Polarize nigra enhances P = .087)]
or 3% astragalosides: Adults: 15 mL glycosides).
macrophages to (Elderberry) phagocytosis Tiralongo E,
400mg – 2000mg In a RDBPCT of 312 transcontinental air passengers 3-4 times daily
M1 activation, Nutrients.
2 week RCT of 82 COPD patients daily. (2016), elderberry extr. taken x 10d before travel, Insufficient
increase dendritic 2016;8(4):18
with acute exacerbation, 15mg twice 4-8mL/day; 30- Jiang D, during travel and x 5d after arrival, in those who Children: 5 mL data to
cell maturation, 2
Astragalus daily of Astragalus extract reduced 60mL/week of 1:2 Biomed Mater developed a cold, they experienced a 2-day shorter 3- 4 times daily recommend
increase T-cell duration (4.75 days vs. 6.88 days) and lower
membranaceus inflammatory cytokines (TNF!, IL-8, tincture Grade C Eng. during PG
mediated symptom severity (21 vs. 34) in comparison placebo.
(Huang-Chi) IL-1", IL-32) and increased T-helper 2015;26(585):S
immunity;
cells, NK cells, and reduced T Ped: 2113 Improves
downregulate Sholto D.
regulatory cells 1-5y = 1/5th adult dose sIgA and
NLRP3 Echinacea reduces duration of URI by an average of - Complemen
5–8y = 1/3rd adult Echinacea reduces pro-
inflammasome .45 days (95% CI 1.85 – 0.94) *did not reach Grade C t Ther Med.
dose spp. inflammatory
signaling statistical significance 2019;44:18-
10y- 15y = ½ adult TNF! and IL-
dose 26
8

Decrease symptoms/severity of infections

Clinically Level of Usnea spp.
Mechanisms Best Evidence studied Evidence & Citations
dosages Harm • Lichen (symbiosis of algae or cyanobacteria and
fungi)
Systematic review and meta-analysis (2017), 33 RCTs Andrographis
• Contains 1-3% by dry weight of usnic acid (soluble
of 7175 participants of all ages with uncomplicated stand. Extr.: 90-
in alcohol and to a lesser extent in hot water)
acute respiratory tract infections or common cold 600mg daily to
• Lichen acids, i.e. usnic acid [antibiotic], polysaccharides
(symptomatic for < 4 weeks) [*note: high risk of bias provide 50 – 180 mg Grade A; mild [immunostimulating], mucilage [demulcent],
Andrographolides
in most studies due to bias in blinding participants] andrographolides adverse effects anthraquinones, i.e. endocrocin [laxative], fatty acids, all
are antibacterial essential amino acids, vitamins, carotene
found Andrographis was more effective than placebo daily (<3%) that
against Gm- and
Gm+ by inhibiting
in overall symptom improvement, cough, sore throat 2-5 mL/day; 20- include N/V, • Antimicrobial against Gm positive bacteria
[n = 445, SMD: -0.69, 95%CI [-1.26, -0.12], and more 40mL/week 1:2 abdominal Hu X-Y, (Staphylococcus aureus and Mycobacterium
biofilm formation
effective than usual care in overall symptom tincture discomfort, PLoS ONE. tuberculosis)
and downregulate
improvement, sore throat, sick leave [n = 1347, RR: dizziness, 2017;12(8):e • Usnic acid is primarily antibiotic, especially against
quorum sensing and
1.36, 95%CI: [1.18, 1.57]. Andrographis plus usual care Typical dosing drowsiness, 0181780 Gm. positive organisms such as: Streptococcus,
pili expression thus Staphylococcus, Mycobacterium tuberculosis and
Andrographis reducing bacteria
was more effective in symptom improvement than duration is 5-7 malaise. other fast-growing species. Usnea spares the gram
paniculata usual care alone [n = 1900, RR: 1.31, 95%CI: [1.16, 1.48] days. Coon J and negative bacteria that colonize the intestinal tract
adherence; antiviral
by inhibiting viral
Ideally start within Adverse effects Ernst E. • Antifungal
are more likely
attachment and viral
Systematic Rev (2004), 7 DBRCTs, n = 896 for 3 days of symptom Planta Med.
• Limited anti-viral activity
Andrographis for uncomplicated URTIs; average presentation; when doses 2004;70:293
replication through
inhibition of
duration of treatment 3 – 7d. Pooled results show improvement reach or exceed . • Binds free radicals and exert cytotoxic effects
Andrographis results in greater improvement in noted in 2 days; 5-10 mg/kg body
proteases; also
overall symptoms, fewer days of sick leave, greater maximal benefit weight of
• Vulnerary
antiparasitic and
eradication of sore throat and fever (compared with seen with 4-5 days andrographolid
antifungal
paracetamol). No significant adverse events e content.
reported. [note: While trials were of good - excellent Ages 8y-18y: 200mg
design, there was a risk of publication bias] standardized
Andrographis extr.

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 2025 Medicines from the Earth Herbal Immunity - Alschuler

• Key indications:
• Gastroenteritis
• Pharyngitis
Spilanthes
• Bronchitis
• Fungal skin infections
acmella
• Impetigo
• Therapeutic dose: 7 –
(Toothache plant)
15mL/day; 50-100mL/week • Herb and flowerhead used
of 1:5 tincture • Contains volatile oils, resins, tannins and
• No known interactions alkaloids
• Sialagogue (when chewed)
Usnea spp. • Note: isolated usnic acid in
dietary supplements • Bitter digestive
(>500mg/day) is hepatotoxic • Anti-inflammatory
due to uncoupling oxidative • Topical analgesic
phosphorylation
(antibacterial MoA) and • Antimicrobial: Spilanthes is a very effective
mitochondrial inhibition addition to formulas containing Echinacea,
as these plants seem to share some of the
• [Chen S, J Environ Sci same medicinal properties.
Health C Toxicol • Spilanthes also appears to have anti-fungal
Carcinog. 2025;43(1):1- and anti-parasitic properties and combines
22] well with other anti-fungal plants such as
Usnea barbata, Hyssopus officinalis, and
other plants with a high content of anti-fungal
volatile oils.
• 10 -15mL/day; 80-100 mL/week of 1:5 tincture

Hemidesmus inducus
(Indian sarsasparilla) Coptis chinesis
• Asclepiadaceae family • Ranunculaceae
• Root used • Rhizome used
• Contains: coumarin, resins, glucosides, tannis, • Berberine alkaloids
triterpenoid saponins
• Anti-inflammatory, Dupurative, Antioxidant, • Medicinal actions: Antifungal, antibacterial,
Mild immunosuppressant, Antibacterial, antidiarrhoeal, anti-inflammatory
Antifungal, Proapoptotic, Anti-ulcerogenic, Anti-
diabetic • Medicinal indications: IBD, SIBO,
• Indications: Autoimmunity, Chronic Gastroenteritis, Infections, URI, Influenza,
inflammation, Bacterial and fungal infections Bronchitis1, Sinusitis, Dermatitis
• Interrupts bacterial biofilms • Infectious and inflammatory conditions of
• Reduces excessive inflammatory responses the mucosa, GI, and skin
giving in primary indication in autoimmune • 3 – 7mL/day; 20-50mL/week of 1:2
diseases and in severe and chronic viral
infections tincture
• Dose: 3 – 8mL/day; 20-60mL/week of 1:2
tincture
1. Han K, Curr Med Res Opin. 2024;40(7):1235

Decrease COVID-19 inflammasome activation & symptoms Decrease COVID-19 inflammasome activation & symptoms
• Plant flavonoids1 (over 6000 flavonoids in edible plants)
Vitamin C • Reduce NFkB and NLRP3 inflammasome signaling
• Reduces NLRP3 inflammasome activation1 • Quercetin2,3 (found in onions and apples): in addition to virocidal and improved innate immunity,
• Shortens frequency, duration and severity of 2common cold and the incidence of quercetin has anti-inflammatory effects, potently inhibiting IL-8 (more effective than cromolyn) and IL-
pneumonia (Sys Rev of human clinical trials) 6. Quercetin (and isoquercetrin) results in 20x higher plasma concentrations of IFN-!
• Increases mRNA expression of IFN! genes in macrophages3 • Garlic4,5: organosulfur compounds activate innate immune cells but also has immunoregulatory and
Melatonin antiinflammatory actions, specifically suppressing inflammatory cytokines such as IL-6, TNF-a.
• 2g fresh garlic increases the level of interferon-" 4x (produced in virally infected cells) and chronic
• Inhibits NFkB and NLRP3 inflammasome4
consumption maintains elevated IFN-"
• Melatonin reduces oxidative lung injury and inflammatory cell recruitment during viral
infections5 • Epigallocatechin gallate (EGCG)5,6 (from green tea) blocks viral attachment and down-regulates
• Induces Sirt1, thereby enhancing the transcription of interferon-producing genes6 proinflammatory cytokines4 including IL-1b5
1. Choe J-Y, Inflammation. 2017;40(3):980
1. Lim H. Toxicol Appl Pharmacol. 2018;355:93
2. Hemila H, Mil Med. 2004;169(11):90 2. Mlcek J. Molecules. 2016;21(5):623
3. Suebsaard P, Vet Immunol Immunopathol. 2021;235:110231 3. Peng D, Biomed Pharmacother. 2020;14(125): article 109984
4. Hardeland R, J Pineal Res. 2018;65(4):e12525 4. Arreola R. J Immunol Res. 2015;2015:401630
5. Silvestri M, Rossi GA. Ital J Pediatr. 2013;39:61 5. Bhattacharyya M. J Interferon Cytokine Res. 2007;27(5):377
6. DiNicolantonio J, Open Heart.2021;8(1):e001568 6. Ge M. Antivral Res. 2018;158:52
7. Ahmed S. Free Radic Biol Med. 2002;33(8):1097

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 2025 Medicines from the Earth Herbal Immunity - Alschuler

Decrease COVID-19 inflammasome activation & symptoms

Decrease COVID-19 inflammasome activation & symptoms

Curcumin, a flavonoid found in turmeric root Mycelium/fruiting body mushrooms* extract1,2 and
• Reduces viral attachment, entry, replication, & fruiting body extract of Agaricus blazeii3: activate innate
activation immunity and increase interferon production, while also
• Suppresses key cytokines involved in the cytokine exerting anti-inflammatory actions, specifically IL-1Ra –
storm of SARS-CoV-19: IL-1b, IL-8, TNFa, IL-61,2 and
reduces cytokine storm associated with severe viral which inhibits the inflammatory effects of IL-1
infections3,4 Mushrooms include: Agaricus, Cordyceps, Enokitake, Amadou,
• Inhibits NLRP3 inflammasome while also inhibiting Agaikon, Reishi, Maitake, Lion’s Mane, Chaga, Shiitake, Mesima, Birch
coronavirus replication through viral protease Polypore, Pearl Oyster, Split Gill Polypore, Turkey Tail
inhibition5,6
• Increases INF-! production7 Matthew D, Hsu W-L. J Functional Foods. 2018;40:692.

1. Abe Y. Pharmacol Res. 1999;39:41

2. Jain SK. Antioxid Redox Signal. 2009;11:241
3. Kedzierski Ll. PLoS Pathog. 2014;10(5): e1004134
4. Sordillo P, Helson L. In Vivo. 2015;29(1):1 1. Davis R, et al. J Inflammation Res. 2020;13:117
5. Yin H. J Immunol. 2018;200(8):2835 2. Benson KF, et al. MC Complement Alternat Med. 2019;19:342
6. Wen CC. J Med Chem. 2007;50(17):4087 3. Tangen J-M. BioMed Res Int. 2015;2015:718539
7. Memarzia A, Biofactors. 2021 Feb. doi: 10.1002/biof.1716

Decrease COVID-19 inflammasome activation & symptoms Decrease COVID-19 inflammasome activation & symptoms

Omega-3 PUFA: suppress pro- Andrographis paniculata:

inflammatory cytokines by suppressing Contains andrographolides that inhibit IL-1b1
gene expression of components of the Reduces duration and symptoms of URIs (esp. cough and
NLRP3 inflammasome. This results in sore throat) [Sys Rev]2
reduced production of IL-1b.1
Astragalus membranaceus:
Oral supplementation with omega-3 Contains astragalosides which inhibit IL-1b induced
PUFAs (360mg EPA and 240mg DHA) inflammation3,4
increased INF-" (~2 pg/mL) (P<0.001) in Reduces replication of avian coronavirus5
40 epileptic patients after 16-weeks of
supplementation
1. Chandrasekaran CV. Antiinflamm Antiallergy Agents Med Chem. 2012;11(2):191.
2. Hu X-Y. PLoS One. 2017;12(8):e0181780
3. He X. Molecules. 2012;17(3):3155
1. Kumar NG. Nutrients. 2019;11:2974.
4. Li H. Immunopharmacol Immunotoxicol. 2019;421(4):497
2. Ghafouri-Fard S. J Mol Neurosci. 2021 Feb 12. doi: 10.1007/s12031-021-01804-y 5. Zhang P. Microb Pathog. 2018;114:124

Conclusions
Improve Innate and
Reduce Risk of Reduce Symptoms of Reduce
Cytotoxic T cell
Infection Infection Autoimmunity
immunity

• Vitamin C • Elderberry • Mushrooms • Melatonin

• Vitamin D
• Astragalus
• Garlic
• Zinc
(Ganoderma,
Cordyceps,
• Vitamin D
• Hemidesmus
Block
viral
Astragalus Thank you!
Coriolus) Quercetin
• Echinacea • Andrographis entry Vit. D
(children) • Usnea
• Spilanthes • Coptis

alschuler@arizona.edu
Covid-19
Vit. D
Vit. C
Melatonin
Flavonoids
Reduce
Curcumin immuno-
Elderberry Prevent
Mushrooms inflammation viral
Omega-3 Zinc replication
Andrographis
Astragalus

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 2025 Medicines from the Earth Oncology - Alschuler

Special Seven: Disclosures

Key Botanicals • Compensated occasional industry-
sponsored webinars and educational
in Integrative presentations:
• NutraBioceuticals, Gaia, NFH, Nordic

Oncology
Naturals

• Co-principal for Thrivers, LLC that runs a

podcast with commercial support from:
Lise Alschuler, ND, FABNO, eMBA • Kyowa Hakko, Essential Formulas,
Associate Director, Fellowship in Integrative Integrative Therapeutics
Medicine
Professor of Clinical Medicine
University of Arizona | Andrew Weil Center
for Integrative Medicine

Outline of Topics
• I will highlight 7 herbs that are
indispensable in my integrative oncology
practice Between 50,000 – 80,000
• For each herb, I will start with a case
vignette, review key oncology-relevant
indications, seminal research studies, This is the number of plants used medicinally
pharmacy, and safety considerations worldwide.
• Herbs to be reviewed are: Chen, SL., Yu, H., Luo, HM. et al. Conservation and sustainable use of
• Curcuma longa • Althea officinalis & Ulmus fulva medicinal plants: problems, progress, and prospects. Chin Med 11, 37
• Cordyceps spp. • Silybum marianum (2016).
• Scutellaria baicalensis • Withania somnifera
• Lavendula officinalis
I will be discussing 7!

Curcumin
Patient Vignette: • Curcumin is the major bioactive component
from the rhizome of turmeric (Curcuma longa)
Turmeric • 0.58% - 3.4% of dry weight of dried turmeric
root
• 70y man with • Also present, at lesser concentrations, are
demethoxycurcumin and
metastatic colorectal bisdemethoxycurcumin
cancer receiving
chemotherapy • Curcumin is associated with anti-inflammatory,
antioxidant, hypoglycemic, wound healing,
• Fatigue antimicrobial, and antitumor activities.
• Unrelated long-standing • Curcumin itself has very poor bioavailability with
mild low back pain only minute amounts reaching peripheral
circulation after ingestion.
Luca S, Crit Rev Food Sci Nutr. 2019;60(4):626
Tsuda T, Food and Function. 2018;9:705

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 2025 Medicines from the Earth Oncology - Alschuler

The Dynamic State of Curcumin Conjugation Bioactivity of Curcumin Metabolites vs.

• Main state of curcumin the body is as
Curcumin
curcumin glucuronide. • Curcumin metabolites, namely tetrahydrocurcumin (THC) and hexahydrocurcumin
• While this form facilitates elimination, (HHC) are more stable than curcumin and possess significant antioxidant and anti-
curcumin glucuronide can also be peroxidation activities
deconjugated in circulation and intracellularly • THC and octahydrocurcumin (OHC) have more potent free radical scavenging activities than curcumin
via B-glucuronidase, increasing tissue • THC activates glutathione peroxidase and glutathione S-transferase more effectively than curcumin
concentrations of free-form curcumin • Curcumin metabolites possess anti-inflammatory activities (inhibition of 5-LOX,
• Free-form curcumin is unstable and most PGE2 and NF-kB) but less so than curcumin.
unconjugated curcumin will degrade into • Curcumin has the strongest antiproliferative actions, however THC and HHC have
bicylopentadione, vanillin and ferulic acid. stronger anti-angiogenic and pro-apoptotic effects
• Furthermore, sites of inflammation increase • Curcumin conjugates (curcumin glucuronide and curcumin sulfate), while weaker than curcumin, inhibit
deconjugation because B-glucuronidase is cell proliferation and inhibit inflammatory PGE2
released at sites of inflammation • THC has more potent hypoglycemic actions than curcumin.
• Inflammation also increases oxidation • HHC has stronger anti-platelet aggregation and vasorelaxant effects than curcumin
(degradation) of curcumin to its degradation
products Tsuda T, Food and Function. 2018;9:705 Tsuda T, Food and Function. 2018;9:705
Schneider C, J Agric Food Chem. 2015;63(35): 7606

Curcumin and inflammation Reduced Risk of Cancer via

— Directly quenches reactive oxygen
Enhancement of Cellular Apoptosis
species (1)
• Apoptosis is the mechanism of programmed
— Inhibits NFkB activation (1) cell death typically in response to oxidative
stress and is an essential component of cancer
prevention.
— Promotes Nrf2 activation (1) • A hallmark of cancer is the evasion of
apoptosis by cancer cells
— Curcumin is a PPAR-γ agonist, leading • Amorphous curcumin (as Curcumin-
to anti-inflammatory and anti- Galactomannoside, CGM, complex) has been
angiogenic effects (2) show in-vitro to selectively upregulate pro-
apoptotic mitochondrial protein, Bax (instrinsic
apoptosis) and to activate apoptotic enzyme
— Activates Vitamin D receptor, leading caspase-8 (extrinsic apoptosis) in malignant
to increased transcription of anti- cells.
inflammatory genes (3) • Additionally, CGM downregulates anti-
apoptotic Bcl-2 and the inactive form of
caspase-8.
1. Surh YJ, Kundu JK, Na HK, Lee JS. J Nutr. 2005 Dec;135(12 Suppl):2993S-3001S
2. Allegri P, et al. Clinical Ophthalmology. 2010;4:1-6
Ratheesh M, et al. Asian Pac J Cancer Prev. 2021;22(6):1713
10
3. Bartik L, J Nutr Biochem. 2010; 21:1153 Tomeh MA, Int J Mol ci. 2019; 20(5):1033

Curcuma longa: anti-inflammation

during chemotherapy Curcuma longa:
• An 8-week randomized, double-blind, placebo-controlled
eight-week trial of 98 adults with solid tumors (primarily
Reduced chemotherapy-induced peripheral neuropathy
breast, colorectal, and gastric) assessed the impact of
curcumin on systemic inflammation.
• Capecitabine (Xeloda®) is associated with a 40% to 50% incidence of hand-foot
• Intervention was 300mg phytosomal curcumin (Meriva;
Indena SpA; Milan, Italy) three times daily, providing 180 mg syndrome (HFS), a form of peripheral neuropathy.
curcuminoids daily.
• In a 6-week pilot study of 40 patients (80% were female and 52% had breast
• Chemotherapy regimens that were commonly used for these cancer) receiving capecitabine, 4g of turmeric (95% curcumin extract), taken as
cancers were:
• docetaxel, cisplatin-5, fluorouracil (5-FU) (gastric cancer and two capsules 12 hours apart, was associated with a reduced incidence of all
breast cancer) grades of HFS.
• topotecan-cyclophosphamide-etoposide (breast cancer)
• cyclophosphamide-methotrexate-5-FU (breast cancer) • The incidence of grade 2 or higher HFS (more severe) was only 10% after the first
• 5-FU-based regimens (colorectal cancer) and second cycles of capecitabine as compared to observed rates of 29% to 38%
• Results: Curcumin supplementation resulted in significantly in placebo groups reported in other trials.
greater improvements in quality of life (QoL) compared with
placebo (P<0.001). • While these data are encouraging, this study is limited by its small size and the
• Additionally, various biomarkers of systemic inflammation lack of a control group.
reduced significantly in the curcumin group, including tumor
necrosis factor-alpha (TNF-α), transforming growth factor-
beta (TGF-β), high-sensitivity C-reactive protein (hs-CRP), and
calcitonin gene-related peptide (CGRP). Scontre V, J Dietary Suppl. 2018;15(5):606
Panahi Y, Phytother Res. 2014;28(10):1461

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 2025 Medicines from the Earth Oncology - Alschuler

Modified Curcumin Note that comparisons of the bioavailability of

different forms is difficult due to differences in
Curcumin: Safety during Chemotherapy • Clinically studied dosages range from 300mg to 8g daily. subjects, curcumin dosages, and blood sampling
time points.
• Liquid extract (1:1 45% EtOH or higher): 5-14 m/day
• Powdered herb: 4g (heaped teaspoon) mixed with water (can add 1 tsp lethicin to improve absorption); 4g –
• IIa open-labelled RCT of 28 patients with metastatic colorectal cancer 8g/day
receiving folinic acid/5-fluorouracil/oxaliplatin (FOLFOX) • 1st Generation Modification:
chemotherapy once every 2 weeks with or without 2g oral curcumin • 95% curcuminoid extract with piperine; 2x AUC all curcuminoids: 500mg curcuminoids with 5mg piperine; 1000mg
daily – 2000mg/day
• Curcumin C3, Sabinsa Corp. containing 80% curcumin and 20% • 25:1 herb:extract; 86% total curcuminoids complexed with essential oils of turmeric; 7x AUC): 800mg –
demethoxycurcumin and bisdemethoxycurcumin daily. 1600mg/day
• Duration: up to 12 cycles of chemotherapy, or patient progression, unacceptable • 2nd Generation Modification:
toxicity, death or withdrawal.
• Water-dispersible colloidal suspension with 30% curcuminoids with 24x AUC): 300mg – 600mg/day
• No differences in adverse events • Submicron colloidal suspension in gum ghatti 30% curcuminoids; 27x AUC): 600mg -1200mg/day
• In the ITT analysis, there was no statistically significant difference in • Curcuminoid phytosome – complexed with lecithin; 30x AUC curcuminoids: 1500mg – 3000mg/day
overall survival or in progression free survival. • 3rd Generation Modification:
• There was a non-statistically significant trend towards longer OS and PFS in the • Amorphous complex of curcuminoids with galactose and mannose polysaccharides; 25x – 39x AUC free
curcumin group. curcuminoids): 320mg – 640mg/day [100mg curcuminoids/320mg CGM]
• Amorphous powder of curcuminoids mixed with starch, ground in distilled water and freeze-dried for stability; 3.7x
higher bioavailability than 2nd generation submicron colloidal suspension): 225mg - 450mg/day [90mg
Howells L, J Nutr. 2019;149&7):1133 curcuminoids/225mg Amorphous curcumin extract]
A good resource: Hegde M, ACS Omega. 2023;8:10713

Curcumin: safety Curcumin CYP activity

• Turmeric has Generally Recognized as Safe (GRAS) status in the United States in doses as high as 10-12g in healthy
individuals (1)
• One case report of iron deficiency anemia with 3g turmeric extract daily (turmeric reduces iron absorption by 20- • Turmeric inhibits CYP3A4 and CYP2C9 in vitro.
90%).(2)
• However, a human pharmacokinetic study found that 4g curcuminoids with 24mg piperine twice daily
• Monitor Hgb with long-term use.
failed to cause changes in plasma levels, clearance, elimination half-life or metabolite levels of
• A handful of case reports (~21) of hepatotoxicity from long-term use have been reported. A review of these cases various CYP3A4 and CYP2C9 probe drugs.(1)
concluded that this toxicity was like due to: added adjuvants that inhibit detoxification enzymes, adulteration with
• Whole turmeric root (> 3g) is a weak CYP2D6 inhibitor (2)
synthetic curcumin or contamination with heavy metals, dyes, mycotoxins, NSAIDs, polyaromatic hydrocarbons or • Weak inhibitors do not alter drug metabolism in a clinically relevant manner, i.e. has no effect boundary
pyrrole alkaloids (3) or due to piperine (4)
• Curcumin (3.6g) is a mild CYP2D6 inducer (3)
• In 2022, the global curcumin market was $242M (over 5 million curcumin supplements)
• This could thereby potentially reduce drug efficacy, however, unlikely to a clinically significant degree. e.g.
• Turmeric is high in oxalates therefore is contraindicated in patients with kidney disease, and those on a low Tamoxifen 7.7% reduction in AUC.
oxalate diet, however, curcumin does not have oxalates. (5) • The phytosomal, or liposomal, form of curcumin minimizes the risk of herb-drug interactions, as compared
to turmeric/curcumin products containing piperine (an alkaloid derived from black pepper [Piper nigrum,
• Daily supplementation of amorphous curcumin at 1000mg daily for 90 days did not cause any adverse effects or Piperaceae]) (4)
alter any parameters of hepatic, renal, or hematological function. (6)
1. Volak LP, et al. Br J Clin Pharmacol. 2013 Feb;75(2):450-62
1. Lao CD, et al. BMC Complement Altern Med, 2006;6:10 2. Al-Jenoobi F, Eur J Drug Metab Pharmacokinet. 2015;40(1): 61
2. Smith T and B Ashar. Cureus. 2019;11(1):e3858 4. Halegoua-DeMarzio D, Am J Med. 2023;136(2):200
5. Panholi V, et al. Toxicol Rep. 2021;8:1255 3. Hussaarts K, Cancers (Basel). 2019;11(3):403
3. Stati G, Front Pharmacol. 2021;12:780330 4. Mach CM, Anticanxer Res. 2010;30(3):811

Patient Vignette: First a bit about Fungi

Cordyceps
• Mushrooms form interconnected networks
• Mushrooms (fruiting bodies) are connected to
• An elder woman with renal cell one another in long filaments, hyphae.
carcinoma is receiving cisplatinum
chemotherapy • The hyphae spread through a substrate and
form a net, or mycelium.
• She has developed signs of renal
insufficiency • Extracts are made from fruiting bodies or
mycelia, or both
• Moderate neutropenia
• Fatigue
• Hx of chronic asthma

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 2025 Medicines from the Earth Oncology - Alschuler

Mushroom dosage forms: Given that polysaccharides

polysaccharide extracts are essentially
Contain:
non-digestable, how do
• Polysaccharides with protein (proteoglycans)
mushrooms have
• These are found as beta-glucans.
• Beta glucans glucose polymers linked together by 1à 3 linear
immunogenic effects?
B-glycosidic chain, in other words, protein-bound
polysaccharides beta-linked by sugar (glucose, galactose,
xylose or mannose) molecules
The apparent paradox of the
• Triterpenes (Reishi), Phenols (Chaga), Purine nucleosides and high bioactivity of mushrooms
adenosine (Cordyceps) given the low bioavailability of
beta-glucans can be explained
Extracts are either: by the fact that the bioactivity
• Hot aqueous – yields high polysaccharides but low triterpenes is derived from interaction
• Ground mushroom cooked in hot water for several hours, fluid is with Gut-Associated
evaporated, and residual is dried. Lymphatic Tissue (GALT) and
• Ethanolic – more triterpenes and fewer polysaccharides
• Combined ( aqueous followed by ethanolic) to give higher yield of
from other metabolites that
both (especially important for Reishi) are formed from gut
Powell M. Medicinal Mushrooms: A Clinical Guide (Mycology Press, 2010)
microbiota
Chilton J. Science and Cultivation of Edible Fungi. Int. Soc Mushroom Science, eds. biotransformation
Baars & Sonnenberg, 2016

Journal of Hematology & Oncology 2009, 2:25 http://www.jhoonline.org/content/2/1/25

Polysaccharide Digestion • Fermented by intestinal microbial flora into Direct Immune Activation by !-Glucans
bioactive short-chained fatty acids (acetate,
propionate, butyrate), and/or, • The innate immune system identifies infectious agents or
compounds by means of Toll-like pattern-recognition
• Bind to specific receptors of immune cells, receptors (TLRs).
and/or, • These TLRs recognize pathogen-specific macromolecules
called pathogen-associated molecular patterns (PAMPs).
• Rapidly internalized by enterocytes (M
cells), enter GALT Peyer’s patches where • Polysaccharides, esp. B-glucan, cannot penetrate cells
they are taken up by dendritic cells. Remain due to their large molecular mass, so the first step in the
modulation of cellular activity is binding to macrophage,
in Langerhans dendritic cells (mucosal dendritic and NK cell TLRs.
dendritic cells) for days. • Glucans are fungal PAMPs for the innate immune system
• Dendritic cells sample the • Mushroom polysaccharides stimulate a predominately
polysaccharides to present them to Th1 (cytotoxic) response via increased production of Th1
specific T lymphocytes in Peyer’s cytokines (IL-2, IL-12, IFN-Y)

Mesenteric lymph nodes

Patches and in mesenteric lymph nodes • Th2 (humoral, or antibody dependent) is generally
suppressed, or activated to a lesser extent, under
• Dendritic cells are the most potent influence of mushroom polysaccharides
Peyer’s patches
white blood cells to rapidly activate
Gao B, J Ethnopharmacol. 2018;224:465
De Jesus M, PLoS One. 2014;9(3):e91002 naïve CD4+ T and CD8+ T lymphocytes Chan GC–F, Chan WK, Sze D M-Y. J Hemat Oncol. 2009;2:25.
Kissenpfennig A, Mol Cell Biol. 2005;25(1):88 Lull C. et al. Mediators of Inflammation. 2005(2):63-80.
Immune3activation induced by β-glucans
Figure
Immune activation induced by β-glucans. β-glucans can act on a variety of membrane receptors found on the immune
cells. It may act singly or in combine with other ligands. Various signaling pathway are activated and their respective simplified
downstream signaling molecules are shown. The reactors cells include monocytes, macrophages, dendritic cells, natural killer
cells and neutrophils. Their corresponding surface receptors are listed. The immunomodulatory functions induced by β-glucans
involve both innate and adaptive immune response. β-glucans also enhance opsonic and non-opsonic phagocytosis and trigger a
cascade of cytokines release, such as tumor necrosis factor(TNF)-α and various types of interleukins (ILs).

Page 6 of 11
Journal of Hematology & Oncology 2009, 2:25 http://www.jhoonline.org/content/2/1/25
(page number not for citation purposes)

plement receptor 3 (CR3) of marginated granulocytes. assessment of safety and tolerability of a soluble form oral
These granulocytes with CR3-bound β-glucan-fluorescein β-glucans [30]. β-glucans of different doses (100 mg/day,
were shown to kill inactivated complement 3b (iC3b)- 200 mg/day or 400 mg/day) were given respectively for 4
opsonized tumor cells after they were recruited to a site of consecutive days. No drug-related adverse events were
complement activation such as tumor cells coated with observed. Repeated measurements of β-glucans in serum,
monoclonal antibody [28] (Figure 2). It was also shown however, revealed no systemic absorption of the agent fol-
that intravenous administered soluble β-glucans can be lowing the oral administration. Nonetheless, the immu-
delivered directly to the CR3 on circulating granulocytes. noglobulin A concentration in saliva increased
significantly for the 400 mg/day arm, suggesting a sys-
Furthermore, Rice PJ et al. showed that soluble β-glucans temic immune effect has been elicited. One limitation of
such as laminarin and scleroglucan can be directly bound this study is the low sensitivity of serum β-glucans deter-
and internalized by intestinal epithelial cells and gut asso- mination.
ciated lymphoid tissue (GALT) cells [29]. Unlike macro-
phage, the internalization of soluble β-glucan by In summary, based on mostly animal data, β-glucans
intestinal epithelial cells is not Dectin-1 dependent. How- enter the proximal small intestine rapidly and are cap-
ever, the Dectin-1 and TLR-2 are accountable for uptake of tured by the macrophages after oral administration. The β-
soluble β-glucan by GALT cells. Another significant find- glucans are then internalized and fragmented into smaller
ing of this study is that the absorbed β-glucans can sized β-glucans and are carried to the marrow and
increase the resistance of mice to bacterial infection chal- endothelial reticular system. The small β-glucans frag-

Complement-dependent Anti-tumor Immunity by !-glucans

lenge. ments are then released by the macrophages and taken up
• Mycelium/fruiting body mushrooms extracts1,2: activate innate immunity and
Human Studies
How β-glucans mediate their effects after ingestion in
by the circulating granulocytes, monocytes and dendritic
cells. The immune response will then be elicited. How-
ever, we should interpret this information with caution as Immunoregulatory increase interferon production, while also exerting anti-inflammatory actions,
specifically by increasing IL-1Ra – which inhibits the inflammatory effects of IL-1b
Actions
human remained to be defined. In a phase I study for the most of the proposed mechanisms are based on in vitro

• Mushrooms include: Agaricus, Cordyceps, Enokitake, Amadou, Agaikon,

• Dendritic cells in GALT as well as
Reishi, Maitake, Lion’s Mane, Chaga, Shiitake, Mesima, Birch Polypore, Pearl
macrophages engulf beta-glucans via TLR2/6
Oyster, Split Gill Polypore, Turkey Tail
receptors and travel to spleen, lymph nodes and bone
marrow.
• In bone marrow and endothelial reticular system,
macrophages degrade B-glucans into smaller soluble
B-1,3-glucan fragments.
• These fragments are released and taken up by
circulating innate immune cells (neutrophils, NK
cells, monocytes and dendritic cells) via complement
receptor-3 (CR3).
• These innate immune cells are then primed to 2 and subsequent actions of β-glucan on immune cells
phagocytize cells which express iC3b (iC3b Figure
The uptake
The uptake and subsequent actions of β-glucan on immune cells. β-glucans are captured by the macrophages via the
opsonized target cells, such as tumor cells and Dectin-1 receptor with or without TLR-2/6. The large β-glucan molecules are then internalized and fragmented into smaller
sized β-glucan fragments within the macrophages. They are carried to the marrow and endothelial reticular system and subse-
infected cells). quently released. These small β-glucan fragments are eventually taken up by the circulating granulocytes, monocytes or macro-
phages via the complement receptor (CR)-3. The immune response will then be turned on, one of the actions is the
phagocytosis of the monoclonal antibody tagged tumor cells.
• Additionally, CR3 binding increases the
expression of anti-inflammatory cytokines (TGF-
B2, IL-10), thereby controlling the Page 4 of 11

immunoinflammatory response. (page number not for citation purposes)

Chan GC–F, Chan WK, Sze D M-Y. J Hemat Oncol. 2009;2:25

Albeituni S, Anticancer Agents Med. Chem. 2013;13(5):689 1. Davis R, et al. J Inflammation Res. 2020;13:117
2. Benson KF, et al. MC Complement Alternat Med. 2019;19:342

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 2025 Medicines from the Earth Oncology - Alschuler

Cordyceps Cordyceps: 8-week RDBPCT of 80 healthy adults

• Beta glucans
• Purine nucleosides (cordycepin)
Innate • Randomized to 1.68g of Cordyceps extract or
placebo
• Adenosine compounds (3’-deoxyadenosine, 2’-
deoxyadenosine, d-mannitol) Immune • Cordyceps resulted in 39% increase in Natural
Killer (NK) cell cytotoxic activity compared to
•
•
Immunomodulatory
Anti-inflammatory
Enhancement placebo. (P<0.019)
• No changes in serum inflammatory cytokines
• Antioxidant suggesting the lack of an inflammatory effect.
• Pro-differentiation
• Anti-proliferative
• Energy-enhancing 4-week RCT of 80 healthy men
• Wild fungus found in Tibet above 10,000 feet. • 1.5g – 3.g (50% alcohol extracts)
• Wild fungus is parasitic and colonizes larvae of moths so • The Cordyceps group showed a statistically
that their body is filled with mycelium such that the significant greater increase in NK cells (P =
fungus is comprised of both the fungus and parasite. .0010), lymphocytes (P ≤ .0001), and Th1
• Wild cordyceps is very rare. cytokines IL-2 (P = .0096) and IFN-γ (P = .0126),
• Market cordyceps is produced from a mycelial strain compared with placebo
(Paecilomyces hepialid) isolated from wild cordyceps and • No adverse effects noted
then fermented. Jung SJ, et al. BMC Complemen Altern Med. 2019;19(1):1-8
Kang H, et al. J Med Food. 2015;18(10):1164

Cordyceps:
Cordyceps: Immunomodulation Adaptogen
• 120week DBRCT of 20 healthy adults ages 50-
75yo
• Retrospective study of 67 kidney transplant recipients.
• Randomized to 333mg cordyceps extract (Cs-4)
• All recipients received anti-rejection drugs (tacrolimus plus prednisone or three times daily or
mycophenolate mofetil plus cyclosporine A) placebo
• 25 also received a dry powder preparation of Cordyceps sinensis mycelia • Cordyceps increased exercise performance:
• 10.5% increase in metabolic threshold
• No differences in survival rate, occurrence of reject reactions or renal function (measured by muscle activity threshold prior
recovery to lactic acid accumulation)
• However, Cordyceps group had lower LFTs, lower infection rates and higher T- • 8.5% increase in ventilatory capacity
(measured by ventilation threshold above
lymphocyte counts (P<0.01). which H+ stimulates ventilation)
• No changes seen in placebo
• No changes in VO2max in either group
• These changes correlate with the ability to
Abstract only, article in Chinese: perform a higher level of exercise without fatigue
Ding CG, et al. Zhongguo Xhong Xi Yi Jie He Za Zhi. 2009;29(11):975.
Chen S, et al. J Altern Complement Med. 2010;16(5):585.

Cordyceps: Dosing
Cordyceps: • A 2-month randomized controlled trial of 60
adult patients with moderate chronic asthma
• 500mg -2g three times daily
• Mycelium extract
Pulmonary • Inhaled corticosteroids and beta-agonists as
needed +/- Cordyceps supplementation
Anti- • Cordyceps group had reduced serum markers
of airway inflammation, including lower IgE,
inflammation sICAM-1, IL-4 and MMP-9 (P<0.05 or P<0.01)

Wang N-Q, et al. Zhongguo Zhong Yao Za Zhi. 2007;32(15):1566.

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 2025 Medicines from the Earth Oncology - Alschuler

Cordyceps is an energizing immunomodulator

Patient Vignette:
Cardiovascular: Anti-inflammatory cardiotonic Chinese skullcap
• 8y boy with childhood acute
Cordyceps Endocrine: Anti-inflammatory; post-infection fatigue lymphoblastic leukemia
• Receiving maintenance
Affinities & Renal: Renal tonic chemotherapy (3rd phase of
treatment) to reduce risk of
recurrence
Energetics Pulmonary: Lung tonic and respiratory anti-
inflammatory
• Chemotherapy is daily 6-
mercaptopurine, weekly oral
methotrexate intravenous
Neurologic: Improves stress response; adaptogenic vincristine with prednisone
every 6 weeks
• Insomnia
Warm (activates, increases internal digestive heat, • Frequent colds
expands and stimulates); sweet

Chinese Skullcap Scutellaria baicalensis: indications

• Scutellaria laterifolia and Scutellaria
baicalensis
• Common names: Chinese skullcap • Suppresses inflammatory cytokine
• Family: Labiatae production (TNF-a, NF-kB, IL-1)
• Parts used: S. laterifolia – Herba; S. • Activates GABA-A receptors and is useful in
baicalensis - radix reducing anxiety and providing related
• Constituents: sedation
• S. laterifolia: Flavonoid glycoside:
scutellarin, scutellarien and others; • TCM: Anti-febrile and detoxification; useful
Iridoids - catalpol; Volatile oil; Waxes; during acute infections
Tannins
• S. baicalensis: Flavonoids: baicalin, • Increases NREM and REM sleep during
baicalein, wogonside, wogonin darkness, and increases wakefulness
• Medicinal actions: during light periods
• S. laterifolia - Sedative, nervine
relaxant, antispasmodic, nervine tonic
• S. baicalensis – Anti-tumor, Anti- Chang HH, et al. J Ethnopharmacology. 2011;135:359-68.
inflammatory, antibacterial, anti-
33
hypertensive, anti-allergy, sedative

Scutellaria baicalensis: Hepatocellular

Scutellaria baicalensis: anti-ALL
carcinoma
• Scutellaria baicalensis root extract inhibits acute B-lymphoblastic • Meta-analysis of 7 clinical and 17 preclinical in vivo studies along with 31 in
leukemia cells, attributable in large measure to baicalin (1) vitro studies were included
• Arrests cell cycle, induces apoptosis via caspase activation. • TCM preparations with Scutellaria baicalensis as the leading herb
• 72% of bone marrow-derived blasts from patients with acute B-lymphoblastic combined with transcatheter arterial chemoembolization or standard
leukemia are sensitive to the apoptotic effects of baicalin and S. baicalensis chemotherapy treatment
extract
• Scutellaria baicalensis significantly improved tumor objective
• In leukocytes obtained from children with acute leukemia, Scutellaria response rate (Risk ratio (RR) = 1.57, 95% confidence interval:
baicalensis extract, concentrated to baicalin, resulted in: (2) [1.30, 1.90], p < 0.00001).
• increased production of IFNy by peripheral blood leukocyte
• increased nonspecific antiviral immunity • In-vivo and in-vitro studies showed slowed tumor growth with
• Also, S. baicalensis induced apoptosis of B-lymphocyte cell lines (without exposure to S. baicalensis extract, baicalein, baicalin, and
affecting healthy lymphocytes) wogonin
• Increased apoptosis
1. Orzechowska B, Int Immunopharmacol. 2020; 79:106114
Ma M-Y, Ann Medicine. 2024;55(2):2247004
2. Orzechowska B, Int Immunopharmacol. 2014;23(2):558

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Scutellaria: Synergistic S. baicalensis: pharmacy

• Powdered root: sig 3-9 gm/day
with Chemotherapeutics • Standardized extract: 90% baicalin: 500mg
daily
• Cisplatin: enhanced cell death, • Tincture
autophagy, reduced drug resistance • Fresh or dried (1:5); sig 2-4 ml TID
• weekly max. = 80 ml of 1:5
• 5-FU: enhanced cell death, reduced
• Fresh 1:2; sig 30 drops TID –QID
drug resistance • Weekly max = 30 ml of 1:2 tincture
• Paclitaxel: enhanced apoptosis • Safety: phase I, RDB, single dose trial of
baicalein (100-2800mg) in 72 healthy adults:
• Gemcitabine: enhanced apoptosis
• Median t ½ life of 0.5-3h for baicalein and baicalin
• Methotrexate: enhanced distribution • No SAEs, only 11 mild adverse events – all resolved.
and tissue exposure of methotrexate • No signs of hepatotoxity or renal toxicity (1)

in the body • Interactions (in-vivo):

• Strongly inhibits CYP2C9 and mildly increases CYP2E1.
• No significant change was observed for CYP3A4. (2)

1. Li M, J Ethnopharmacol. 2014;156:210
Xhou X, Biomed Pharmacother. 2021;138:111445
2. Xhou X, Biomed Pharmacother. 2021;138:111445

Patient Vignette: Lavender officinalis

Lavender • Contains volatile oil, primary active constituents of
which are linalool and linalyl acetate – considered
responsible for the anxiolytic effects
• 54y woman with • Potentiates GABAA receptors, inhibits glutamate
ER+/PR+/Her2n- stage II breast binding in brain
cancer • Over 400 RCTs on lavender and anxiety
• Review included 15 RCTs, involving 1565 participants
• Completed partial mastectomy, • 8 trials investigated the effects of lavender
chemotherapy and radiation inhalation, with 4 reporting a significant positive
effect for at least one anxiety measure
• Now taking Tamoxifen • 3 trials assessed oral lavender
• Experiencing hot flashes with • Of these trials, 7 reported a significant positive effect
panic for at least one anxiety measure.
• Effective studied dose = 20-80mg per day; also use
• Also, underlying anxiety topically, as tea, as aromatherapy

Perry R. et al. Phytomedicine. 2012;19(8-9):825-35.

Lavender: Lavender
Clinical
Indications
• Anxiety
• Mild depression
• Insomnia
• Bacterial and Fungal infections
• Topically for acne and
inflammation
• Dyspepsia, colic
• Tension h/a, migraine h/a
• Spasmodic dysmenorrhea

Kasper S, et al. Int Clin Psychopharmacol. 2010;25(5):277.

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Lavender Lavender aromatherapy:

• An oral lavender preparation (Silexan®, WS 1265) was compared to Insomnia & Fatigue in
low-dose lorazepam (Ativan®) for the treatment of GAD. Multiple Sclerosis
• Multicenter, DBRCT, Jadad score of 4
• Insomnia and associated fatigue
• N = 77 adults (2/3 were female) with GAD (HAM-A > 18) affects 1/3 to 2/3 of all MS patients.
• Lavender extract compared to lorazepam x 6 weeks • 63 patients with MS diagnosed at least
1 year previously and with fatigue and
• Primary outcome measure: HAM-A score insomnia were randomized to either
• The mean of the HAM-A total score decreased from 25+/-4 points control or treatment with lavender
at baseline in both groups and to a similar extent in both groups: aromatherapy.
• by 11.3+/-6.7 points (45%) in the lavender group; response • Treatment: three drops of lavender
rate of 52.5% essential oil were applied to two
cotton pads and placed 15-20cm
• by 11.6+/-6.6 points (46%) in the lorazepam group; response from the pillow each night 30 min
rate of 40.5% before bedtime x 30 nights.
• At study end, 40% of lavender group vs. 27% of conventional • The lavender aromatherapy improved
group were in remission (HAMA <10) sleep quality (measured by PSQI score
with mean improvement of 3 points,
• Unlike lorazepam, lavender has no potential for drug abuse or p<0.001).
sedative effects.
• There was no improvement in the
control group
Woelk H and S. Schlafke. Phytomedicine. 2010;17(2):94-9. 43
Kavuran E and Yurttas A. Niger J Clin Pract. 2024; 27(5):635

Lavender: Safety
• There is concern that lipophilic estrogenic components of lavender could accumulate in adipose tissue and, upon
continuous exposure, potentially act as endocrine disruptors.
Lavender • There are several case reports which describe prepubertal gynecomastia in boys in association with topical lavender use (1)

officinalis: Dosing
• A case report series published in 2019 found three prepubertal girls with premature thelarche (prepubertal breast
development) and one boy with gynecomastia from continuous topical exposure to lavender essential oils and lavender
fragranced products over several months to years (2)
• In all cases, breast development resolved after discontinuance of the lavender products without recurrence.
2 teaspoons (10 grams) infusion with 1 cup
(250 ml) of boiling water for fifteen minutes. • However, in all of these case reports, the lavender was not well characterized. The products in these case
Three cups (750 ml) can be consumed each studies were later chemically analyzed and found to have synthetic endocrine-disrupting chemicals while
day. lacking lavender essential oil, instead having ‘lavender extract’ or ‘lavender fragrance’. (3)
1:5 dry herb tincture: 1/2–3/4 teaspoon (2–4 • In a systematic review, which included the 2019 Ramsey publication, it was concluded that there is little to no
ml) of tincture can be taken BID or TID evidence that lavender acts as an endocrine disruptor in children nor that it has significant estrogenic
effects. (4)
1:2 dry herb tincture: 15-30mL per week
• Additionally, inhalation of lavender essential oil did not increase salivary estrogen concentrations in
Standardized oil extract: 80 – 160mg daily perimenopausal women (5)
• This is supported by an in-vivo study that found no estrogen receptor activation or proliferation effects from lavender
essential oil on breast cancer cells (MCF-7) (6)
1. Diaz A, J Pediatr Endocrinol Metab. 2016;29(1):103 4. Hawkins J, Complement Ther Med. 2020;49:102288
2. Ramsey J, J Clin Endocrinol Metab. 2019;104(11):5393 5. Shinohara K, Neuro Endocrinol Lett. 2017;37(8):567
3. Giroux J-M and Orjubin M. J Clin Endocrinol Metab. 2020;105(7):e2677 6. Simoes B, Ther Adv Med Oncol. 2018;10:1758835918766189

Patient Vignette: Components of the

Marshmallow root & intestinal mucosal layer
Slippery elm bark • Intestinal mucosa is comprised of the epithelium, lamina
propria and muscularis mucosae layers
• Central to the intestinal lumen and a part of the mucosa is a
• 40y woman receiving radiation layer of mucus
therapy for metastatic ovarian • Mucus is a gel-like layer comprised of mucins
cancer • 90% water
• Mucins = large glycosylated proteins:
• Hx of bowel obstructions after • Transmembrane mucins cover enterocytes and
initial pelvic surgery form the glycocalyx which protect the epithelium
and provide a surface for attachment of
• Currently experiencing commensal bacteria
constipation • Gel-forming mucins (mostly MUC2) are secreted by
Goblet cells and form protective net-like layers over
epithelial surfaces
Johansson M and Hansson G, Nat Rev Immunol. 2016;16(10):639
Eutamene H, et al. Exp Rev Gastroent Hepatol. 2018;12(1):83

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Intestinal mucus Demulcents

• Mucus = Gel-like layers
loosely adherent to the • Deficiencies in the intestinal barrier
caused by neuroendocrine
epithelium
mediators, immune activation,
• Is a complex colloid infections, acute toxicants and
comprised of hydrophilic
mucins (branched inflammants, ingested toxins, etc.
glycoproteins) lead to altered intestinal barrier and
• Contain antibacterial • Small intestine: single layer of • Large intestine: mucus consists of increased intestinal permeability
peptides and proteins that mucus produced by Goblet cells two layers (esp. in distal colon)
• Loosely attached to epithelium, • adherent, mostly sterile inner
• Mucoprotectants, which provide a
kill or trap bacteria
easily penetrable due to the mucus layer produced by Goblet protective film over the intestinal
• More than 20 subtypes in
humans; major mucin in presence of mucus pores which cells mucosa, are one way to reduce
the intestines is mucin-2 allow for nutrient uptake • loosely adherent outer mucus intestinal permeability and improve
• Contains antibacterial layer which contains colonic
(MUC-2)
modulators to repel pathogenic microbiota. These commensal
the function of the intestinal barrier.
• Mucus hydrates and bacteria including defensins, bacteria secrete mucinases and • Demulcents are botanicals with high
lysozymes and peptides proteinases that degrade the
protects the epithelium secreted by Paneth cells outer mucus contributing to its
concentration of
• Fluids and motor activity move irregular and less adherent mucopolysaccharides which provide
the mucus and trapped bacteria consistency mucoprotection
Herath M, et al. Front Cell Infect Microbiol. 2020;10:249 to the colon • Mucus layer is thinner on right side of
Eutamene H, et al. Exp Rev Gastroent Hepatol. 2018;12(1):83 colon and thickens distally Eutamene H, et al. Exp Rev Gastroent Hepatol. 2018;12(1):83

Ulmus fulva Ulmus fulva (slippery elm) and Microbiome

(Slippery elm) bark
• Slippery elm is known to contain a high content of polysaccharides, including linear chains of
• Slippery elm powder derived from alternating D-galacturonic acid and L-rhamnose residues with !-linkages containing galactose
the tree bark has a high and 3-O-methyl galactose1
concentration of • In vitro anaerobic cultivation of human fecal inoculums from 12 healthy vegetarian donors with
mucopolysaccharides Triphala, slippery elm, or Licorice resulted in increased microbial diversity. 2
• Slippery elm resulted in 299 unique bacterial species belonging to 131 genera
• These undigestable
• Inoculation with Triphala and Glycyrrhiza glabra produced similar results
mucopolysaccharides are
mucoprotectants • Predominant bacterial species differed by herb:
• Triphala (Emblica officinalis, Terminalia bellerica, and Terminalia chebula) induced large increases in the
• These mucopolysaccharides are relative abundance of Dorea, Sutterella, Phascolarctobacterium, Lactobacillus, and Butyrivibrio
hydrophilic mucoprotectants, (range=116–580-fold).
provide substrate for commensal • Slippery elm yielded similar outcomes also with large increases for Dorea, Sutterella, and
bacteria, and bulk and lubricate the Phascolarctobacterium (range=169–298-fold)
stool. • Licorice produced comparable increases for Pseudomonas, Acinetobacter, Victivallis,
Acidaminococcus, Phascolarctobacterium, and Sutterella.
• No clinical studies to date
demonstrating the mucoprotection
L 1. Hough L, et al. Nature. 1950;165:134
2. Peterson CT, et al. JACM, 2018;24(7):656

Slippery Elm dosing

• Ulmus often works the best if dosed frequently.
• Gruel: Mix 1 Tablespoon powder to 4 ounces cold water
Althea officinalis
(cold water best extracts the mucilage). Let sit for at
least 10 minutes. Add to hot cereal or 1 cup hot water.
Add cinnamon and/or honey. Eat or drink in two to three
(marshmallow)
divided doses.
• Children: use Young’s Rule = add 12 to the child’s
age and then divide the child’s age by this summed
number. The result is the fraction of the adult dose • Root and leaves contain Mucilage: hydrophilic
to use. polysaccharides
• Physically contribute to outer mucin layer in intestines
• Decoction: Mix 1 part powder to 8 parts water (mix the
powder with small amount cold water first to ensure the • Also contain flavonoids, polyphenols, vitamins, terpenes,
extraction of the mucilage). Boil gently for 15 minutes tannins
and let cool; sig 1/2 cup TID • No clinical studies L
• Decoction: Mix 1 tsp. bark into 1 cup cold water. Let sit
for 4-12 hours, strain; sig 1/2 cup BID-QID.
• Theoretically, slippery elm could slow the absorption of
oral drugs taken concurrently. Slippery elm is safe for
children and the oral use is safe for pregnant women. Sharifi-Rad , Phytother Res. 2020;34(3):546.

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Marshmallow Root
Latte
Marshmallow dosing
• 6 ounces marshmallow root tea
• 6 ounces oat milk (a demulcent!)
• Infusion: 2-4 g/cup cold water, infuse
overnight; 1 cup TID [1 tsp. = 1.4 g] • 1/2 -1 teaspoon maple syrup
• Children under age 8y: 1g/cup; 1 cup daily • Pinch nutmeg
• Tincture: 1:5 25% EtOH; sig 1-4 ml TID;
weekly max. dose is 100 ml • Prepare marshmallow root tea day prior.
• Children 2- 8y: 1ml BID Combine 1 teaspoon marshmallow root
powder and 12 ounces water in Mason jar,
• Well-tolerated; safe in children refrigerate overnight.
• No known interactions; could interfere with Combine all ingredients in small saucepan,
absorption of oral drugs bring to gentle simmer. Pour into mug and
enjoy

Clinical vignette: Silybum marianum:

Milk thistle Description
• Also known as St. Mary’s thistle
• 75y man with colorectal cancer, metastatic
to liver receiving FOLFIRI chemotherapy • Member of Asteraceae (Daisy) family
• Elevated liver enzymes prior to • Seeds (fruits) contain:
chemotherapy • Flavolignans: 1.5 - 3%
• Milk thistle standardized extract, 420 mg • Silymarin: silybin (70%), silydianin,
extract (80% silymarin) once daily (in the silychristin
evening) • Oil (oleic acid, palmitic acid)
• Also consider: • Sterols (cholesterol, campesterol,
• Active hexose correlated compound stigmasterol, sitosterol)
(Shiitake mushroom extract): 1.5g twice • Mucilage
daily
• Milk thistle has been used for centuries to
• Probiotic (Lactobacillus/Bifidobacter) protect liver from toxins and to treat hepatic
50B damage

57

Silymarin: main biologically active constituent Medicinal Actions

• Part flavonoid (taxifolin) and part lignan, joined through oxidative
coupling • Antioxidant
• Anti-inflammatory
• Seven flavonoids:
• silybin (70%) consisting of two diastereomers silybin A, silybin
• Hepatoprotective
silybin B • Bitter
• isosilybin (5%) (as isosilybin A and isosilybin B) • Cholagogue
• silychristin (20%) (with isosilychristin) • Nephroprotective
• silydianin (10%) • Pro-apoptotic
• Extracted silymarin is 70-80% silymarin flavonoids and 20-35% fatty • Galactagogue: (safe during breast feeding)
acids. • Anti-viral
• Most biologically active flavononlignan is silybin.
• Photoprotectant (topical)
Wadhwa K, Molecules. 2022;27(16):5327
AbouZid S. Silymarin Flavonolignans. Studies in Natural Products Chemistry. 2013
59
Jaggi A, Singh N. Adv Exp Med Biology. 2016;929:25

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Hepato- Hepatoprotective: Mechanisms of Action

protective • Decreases intracellular production and release of transaminases (AST, ALT, GGT, ALK)
• Improve hepatocellular membrane integrity
• Increases Nrf-2 non-enzymatic antioxidant response system and downregulates NFkB
• Increases enzymatic antioxidants (glutathione, Se transferase)
• Reduces pro-inflammatory inflammatory cytokines by mpeding NLRP3 inflammasome
activation and the release of inflammatory cytokines (TNF-a, IL-6, IL-1B, IL-12B,TGFb etc)
• Pro-apoptotic and anti-apoptotic (counters the oxidative stress induces inflammatory
stimulation of caspases)
• Reduces hepatic fibrosis by reducing hepatic stellate cells and Kupffer cells thereby
reducing their translation into myofibroblasts
• Myofibroblasts normally exude extracellular matrix proteins contributing to inflammation
• Reduce collagen and procollagen required in fibrosis and increases MMP-2, thereby
preventing fibrosis
• Blocks and inactives oxidative hepatotoxins
• Triggers hepatic regeneration by increasing RNA and RNA polymerase I synthesis thus
repairing damaged liver cells

Wadhwa K, Molecules. 2022;27(16):5327 61 Wadhwa K, Molecules. 2022;27(16):5327

Silymarin: Liver Enzymes Milk thistle: Hepatoprotection from toxicants

• Systematic review of 29 RCTs (n=3,846) • A controlled clinical trial was conducted with 49 workers with a 5 – 20 year exposure to
toluene and/or xylene vapors and with elevated AST and ALT, and/or abnormal
• Participants had a variety of underlying conditions hematological values including low platelet count, leukocytosis, or relative lymphocytosis
• Silymarin dosages ranged from 140mg to 420mg for varying • Thirty workers were treated with oral Legalon® (140mg milk thistle standardized extract)
durations TID x 30 days and compared to 19 workers without any intervention.
• The milk thistle was associated with improved AST, ALT, platelet counts.
• 65.5% of the studies reported reduced liver enzyme (ALP, ALT, AST)
levels, 20.7% exhibited no significant change, and 13.8% • There was a nonsignificant trend of improvement for leukocytosis and relative
observed elevated liver enzymes. lymphocytosis.
• Of note the 13.8% studies that observed increased liver enzymes utilized
low doses
• Doses associated with liver enzyme reduction were 200-400mg silymarin
daily.

Martinez E, Cureus. 2023;15(10):e47608 63 Szilard S, Acta Med Hung. 1988;45(2):249 64

Anti-cancer Anti-cancer: Mechanisms of Action

• Causes cancer cell cycle arrest at G1/S-phase
• Preserves apoptosis proteins
• Inhibits survival and growth kinase pathways (MAPK, ERK1/2, JNK
1/2)
• Downregulates inflammatory transcription factors
• Reduces invasiveness, metastasis and angiogenesis

65 Wadhwa K, Molecules. 2022;27(16):5327 66

Wadhwa K, Molecules. 2022;27(16):5327

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Milk thistle: Chemotherapy toleration, Milk Thistle: Chemotherapy-Induced

pediatrics Hepatotoxicity
• RDBCT pilot study, 50 children with acute lymphoblastic leukemia • Randomized, triple-blind, placebo-controlled trial of 30 patients with
(ALL) and hepatic toxicity were randomized to receive 5mg/kg non-metastatic breast cancer and with at least grade 2 liver injury
based on ultrasound
standardized milk thistle extract or placebo
• Patients were randomized during the 4th and final cycle of dose-dense
• No significant differences in the frequency of side effects, Adriamycin/Cytoxan prior to paclitaxel
incidence, and severity of toxicities or infections were observed • Over 1 month, the women received either the intervention of 140mg of
between groups. silymarin three times daily or the control of milk thistle without
• However, at day 56, the milk thistle extract group had a silymarin.
significantly lower AST (P = .05) and a trend toward a significantly • After one month of supplementation, there was a non-significant trend
lower ALT (P = .07). in reduction in fatty liver; however, there were no significant differences
in severity by FibroScan or liver function tests.

Ladas E, Cancer. 2010;116(2):506 Moezian G, J Oncol Pharm Pract. 2022;28(4):827

67 68

Milk Thistle: Chemotherapy-Induced

Milk thistle: Radiotherapy-induced mucositis
Hepatotoxicity
• Pilot DBRPCT of 27 patients with head and neck cancer receiving
• Pilot study of 70 patients with metastatic colorectal cancer
radiotherapy.
receiving first-line FOLFIRI chemotherapy (5-
fluorouracil/leucovorin/irinotecan) with bevacizumab. • Intervention: Oral silymarin, 420mg in 3 divided doses starting on
day 1 of radiotherapy and continuing to the end of radiotherapy in
• Oral dosing of 150mg of milk thistle extract three times daily for 1
6 weeks
week resulted in less diarrhea (5.7% v 14.6%, p= 0.002) and less
nausea (27% v 40.2%, p=0.005) compared to controls • Cisplatin was administered by infusion every 21 days x 3 cycles

• There was no difference in liver toxicity; however, this trial was • Although mucositis scores increased in both groups, the
likely of insufficient duration to assess this. mucositis was delayed in the silymarin group and the scores were
significantly lower in silymarin group (p<0.05)

Elyasi S, Phytotherapy Res. 2016;30(11):1879

Chang TK, Oncol Res. 2021;28(7):801 69 70

Topical Milk thistle: Capecitabine-induced

Hand-Foot Syndrome Pharmacy
• RDBPCT of 40 patients with GI cancer and receiving capecitabine • 30:1 seed extract
chemotherapy. standardized to 80% silymarin
• 140mg – 450mg TID or 420mg –
• Randomized to silymarin gel 1% applied to palms and soles twice 1350mg once daily
daily starting with chemotherapy x 9 weeks or placebo. • Children: 140mg daily
• Median HFS scores were significantly lower in the silymarin group • 12-15g seed (providing 200-
by 9 weeks (p<0.05) although the HFS scores did increase in both 400mg silymarin)
groups. • Poor bioavailability due to low
• Silymarin group took longer to develop HFS and developed less severe aqueous solubility
HFS. • This is overcome with silymarin
nanoparticles and phytosomes
(phosphatidylcholine complex)
Elyasi S, Phytotherapy Res. 2017;31(9):1323.
71 Wadhwa K, Molecules. 2022;27(16):5327

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Contraindications & Drug/Herb Interactions Patient Vignette:

• Well-tolerated. Ashwagandha
• Considered safe during pregnancy and breast-feeding
• May inhibit drug efflux pumps thereby reducing resistance to antibiotics and • Middle-aged executive who has
oral chemotherapy resistance recently completed treatment for
• Therefore, milk thistle is ideally suited during antibiotic therapy, especially sarcoma
with hepatotoxic antibiotics • No evidence of disease, however,
• In-vivo studies have found silymarin flavonoids to inhibit cyp3A4 and significant anxiety with each post-
cyp2C9, however, these effects have not been demonstrated in humans treatment scan
and are considered to not be clinically relevant (1) • Also, experiencing high stress from
• Silymarin (140mg TID x 14d) has been shown increase AUC of losartan in work, residual treatment fatigue and
individuals with CYP2C9*1/*1 genotype (2) mild treatment-related anemia
1. Loguercio C, World J Gastroenterol. 2011;17(18):2288
2. Han Y, Eur J Clin Pharmacol. 2009;65(6):585 73

-
Adaptogens GR activation
FKBP5
- Adaptogens
Negative Feedback:

Ashwagandha • Innocuous
• Have a normalizing action, irrespective of the direction
CRH & ACTH

• Withania somnifera of the pathologic state

• Solanaceae • One key mechanism of adaptogens is to restore
• Part used: Root intracellular glucocorticoid receptor (GR) sensitivity in
• Constituents: Alkaloids: isopelietierine, the brain, and thereby reinstating negative feedback.
anaferine; Steroidal lactones: withanolides,
withaferins; Saponins; Iron • In the brain, GR activation inhibits genes that encode for CRH
and ACTH.
• Medicinal actions: Hypotensive,
bradycardic, spasmolytic, anti-tumor, • Adaptogens:
immunomodulating, anti-inflammatory,
adaptogenic, sedative. • Inhibit FKBP5. FKBP5 reduces the affinity of glucocorticoids to GR
• Withania is adaptogenic and tonic, and delays translocation to the nucleus. Inhibited FKBP5 restores
stimulating weight gain, increased cell intracellular GR activation with resultant inhibition of CRH and ACTH
counts and reducing inflammation • Inhibit of COMT (catechol-O-methyl transferase) which otherwise
degrades cortisol in the region of GR receptors Gaffney B. Med Hypotheses. 2011;56(5):567-72
Zannas AS, Neuropsychopharmacology. 2016;41:261-74
75 76
Verjee S, Planta Med. 2018;84(9-10):696.

Panax
ginseng
(Asian
Ashwagandha:
Rhodiola
rosea
ginseng) Mechanism of Action
Stimulating • It is best suited to individuals who are debilitated
Ocimum and who suffer from nervous exhaustion and
sanctum anemia.
(Holy Basil) • Withania is helpful in convalescence after acute
Energizing, Uplifting
illness or stress, impotence, chronic disease with
Cordyceps
inflammation and bony degeneration, as a
general tonic and adaptogen.
• Withania exerts a sedative effect and thereby
Eleutherococcus Builds stamina & resilience rests and restores the health of the nervous
senticosus system and person overall.
(Siberian ginseng) • High doses of the alkaloids have demonstrated
Lepidium prolonged hypotensive, bradycardic, respiratory
peruvianum Anti-inflammatory; Anxiolytic stimulant and cerebral depressant effects by
(Maca) binding to and stimulating GABA-A receptors.
• The alkaloids are spasmolytic to smooth muscles
Withania Restorative systemically and exert an overall sedative action.
somnifera
(Ashwagandha) 78
Malhotra CL, et al, Ind J Med Res, 49, 1962:448.
Sedative Malhotra CL, et al, Ind J Physiol Pharmacol, 9, 1965:9.

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Withania somnifera
(Ashwagandha): stress Ashwagandha: Anxiety and stress
• Ashwagandha – restorative, calming
• Exerts a calming, anxiolytic, slightly sedative effect, • Systemic review of ashwagandha for anxiety and stress.
while also supporting cognition, and thereby rests
and restores the health of the nervous system and • Of 62 screened, 5 human trials met inclusion criteria.
person overall. • 3 studies compared several dosage levels with placebos for anxiety and, of
• 300mg full spectrum concentrated Ashwagandha these, 2 showed significant benefit of ashwagandha over placebo and the 3rd
extract twice daily or placebo. The ashwagandha showed a trend towards benefit.
group experienced significant reduction in all
measures of stress compared to placebo (p<0.0001) • One study compared naturopathic care with ashwagandha versus
and experienced reduced cortisol level (27.9% psychotherapy for anxiety. Anxiety scores decreased by 56.5% in
reduction) compared to placebo (7.9% reduction)
(p=0.0006) naturopathic/ashwagandha group and by 30.5% in psychotherapy group.
Not recommended during • Chandrasekhar K, 2012. PMID: 23439798 (p<0.0001)
• Pregnancy (may have • 39 patients with ICD-10 classified anxiety disorders • The 5th study measured changes in Perceived Stress Scale scores in
abortifacient effects) were randomized to receive an ethanolic extract of ashwagandha group versus placebo and there was 44% reduction in stress
• Lactation (unknown safety) Withania somnifera or placebo x 6 weeks. 88% of scores in ashwagandha group and a 5.5% reduction in placebo group
• Children: safety established ashwagandha subjects showed reduction in anxiety (p<0.0001).
compared to 50% of the placebo subjects.
for anxiety and ADHD; Ashwagandha was well-tolerated. Pratte MA, et al. J Altern Complement Med. 2014;20(12):901-8.
recommend > 10y • Andrade C, 2000. PMID: 21407960 80

Ashwagandha: Fatigue Ashwagandha: Endurance effects

• Ashwagandha improves cardiorespiratory endurance.
• 12-week DBPCT of 50 adults (male and female)
• Two-arm, parallel 12-week RDBPCT • Ashwagandha resulted in greater oxygen consumption at peak physical exertion
(+5.67 increased VO2max) compared to placebo (+1.86 increased VO2max).
• 120 overweight adults (40-75y of age) (P<0.0001)
• Ashwagandha was KSM-66 [full-spectrum root extract], 300mg (1 capsule) twice daily
• Intervention = standardized ashwagandha root extract, Witholytin® • VO2 max = a person’s ability to take in, transport, and utilize oxygen and is probably the best
• 200mg standardized to 1.5% withanolides assessment of endurance capabilities.
• Ashwagandha improved all measured aspects of QoL (physical health,
• Dose was 200mg twice daily psychological health, social health) at 12 weeks compared to placebo (P<0.05)
• Stress scores reduced by 39.5%, however, this was not different than
placebo
• There was a statistically significant reduction in fatigue in the ashwagandha
group compared to placebo (p=0.016)

Choudhary B, Ayu. 2015;36(1):63.

Smith S, J Psychopharmacol. 2023;37(11): 1091

Ashwagandha: Insomnia Ashwagandha: Immune Effects

• 8-week parallel RDBPCT of 80 adults; 40 healthy and 40 with delayed onset and poor sleep quality • Immunomodulator:
insomnia randomized to placebo or 300mg ashwagandha standardized extract (KSM-66®) capsule • Enhances NK cell proliferation and activity1, 4
twice daily • Increases Th1 cell-mediated immunity by increasing
• KSM-66 is a 15:1 extract standardized to withanolides >5% IFNy, IL-2 while decreasing associated inflammation
• In both healthy and insomnia subjects, there was a significant improvement in the sleep parameters in by lowering TNFa2, 3, 4
the Ashwagandha root extract supplemented group. • Prevents IκB degradation thereby decreasing NF-κB
nuclear translocation and NF-κB binding to DNA
• The improvement was found more significant in insomnia subjects than healthy subjects. transcription sites of various inflammatory cytokines1
• Significant improvement in sleep onset latency (p < 0.013), HAM-A outcomes (p < 0.05), mental • Withania extracts also attenuates
alertness (p 0.01), and sleep quality (p < 0.05) of the insomnia patients. immunoinflammation by increasing IL-10 secretion
• Sleep onset latency (p < 0.0001) and sleep efficiency (p < 0.0001) were the most improved (immunosuppressive)5
parameters, followed by total sleep time (p < 0.002) and wake time after sleep onset (p < 0.040). • Protects against immunosuppression (increases
WBC and PLTs) in cyclophosphamide-induces
immunosuppression6
1. Malik, F, et al. Eur J Cancer. 2009;45(8):1494.
2. Kaur P, et al. Biomed Pharmacother. 2017;95:1815.
3. Malik, F, et al. Life Sci. 2007;80(16):1525.
4. Mikolai J, J Altern Complement Med. 2009;15(4):423.
Langade D, J Ethnopharmacol. 2021;264:113276 5. Khan MA, et al. Antiinflamm Antiallergy Agents Med Chem. 2019;18(1):55
6. Agarawal R, et al. J Ethnopharmacol. 1999;67(1):27.

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 2025 Medicines from the Earth Oncology - Alschuler

Curcuma anti-inflammatory; improves chemotherapy

longa:
3-6 g/day of dried root tolerance
Cordyceps energizing; improves anti-tumor innate and
1:5 tincture --- 12-25 ml/day; 1:2 tincture—6-12 ml/day spp.:
cytotoxic immunity, reduces inflammation

In Summary: Scutellaria anti-tumor, anti-inflammatory, synergistic

Ashwagandha:
450 – 900mg standardized extract to at least 2.5% withanolides
baicalensis:

Dosing
Note: Clinical effects are usually not seen for at least 1 month. In India, ashwagandha
is given with pungent, heating herbs (ginger, pepper) to increase its tonic effects.
7 (8 really) Lavendula
with chemotherapy

reliable anxiolytic, not estrogenic

Toxicity: Mild and occasional reports of h/a, nausea. Use with caution in
hyperthyroidism as may increase thyroxin levels
indispensable officinalis:

Interactions:
herbs in Althea
officinalis &
Ulmus fulva:
demulcent; reduces intestinal inflammation
during chemotherapy and radiation

- Additive effects with: hypoglycemic drugs, antihypertensive drugs, benzodiazepines, integrative Silybum
marianum:
antihepatotoxic, antitumor, improves

oncology
CNS depressants chemotherapy toleration

- May counteract immunosuppressants Withania adaptogen; reduces stress, anxiety and

somnifera:
fatigue

Thank you!!
Alschuler@arizona.edu

21
2025 Medicines from the Earth Resilience - Boardwine

Nourish Resilience with Herbs

re·sil·ience
Resilience, a noun meaning, “the capacity to withstand or to recover quickly from
difficulties; toughness”, as defined by Webster dictionary.

Resilience was coined before Resiliency and is considered the etymon. Etymology is important
in understanding the derivation of a word and the root which many others form. The two nouns
mean exact same and are synonyms. Mar 20, 2019, Medium.com Blog written by Nina Flagler
Hall

The American Psychological Association defines resilience as “the process of adapting well in
the face of adversity, trauma, tragedy, threats or even significant sources of stress”. Resilience
refers to the ability to successfully adapt to stressors, maintaining psychological well-being in the
face of adversity.

“Resilience can be defined as “positive adaptation”. Resilience construct has its roots in
developmental psychology where researchers laid the foundation for defining and
conceptualizing resilience at the individual level. (Garmezy, Werner, & Smith).

In terms of a general definition of individual resilience, two concepts can be regarded as

fundamental: adversity and positive adaptation (Luthar, Cicchetti & Wright).

Individual resilience is primarily influenced by early life experiences and the impact of parents’
behavior, in early success experiences, and in early crisis experiences.

“We talk about resilience as a muscle that needs to be built. And unless you keep that muscle in
shape, it can atrophy”. Bob Sternfels, delivered this statement at the recent 2024 World
Economic Forum. Developing resilience is a necessary skill for leaders.

Resilience is strengthened by plant medicines. In this mission statement by Nicole Rose of

Solidarity Apothecary states, “The mission of the Solidarity Apothecary is to materially support
revolutionary struggles and communities with plant medicines to strengthen collective
autonomy, self-defense and resilience to climate change, capitalism and state violence.”
https://solidarityapothecary.org/

“We talk about resilience as a muscle that needs to be built. And unless you keep that muscle in
shape, it can atrophy”. Bob Sternfels, Global Managing Partner at Mckinsey and Co. Sternfels
believes developing resilience is a necessary skill for leaders. This quote was delivered in a
speech at the World Economic Forum in Davos, 2024.

Tori Hudson, ND discusses resilience in;” Resilience: The Role of Herbal Medicine for Anxiety
and Depression”. Tori mentions that, “in integrative healthcare the role of the practitioner is to
help the patient to become strong, healthy and successful after a challenging event. This role of
building resilience is not just up to the practitioner but also the individual needs to take an active
role in their own recovery to return to healthy, problem solving, spiritually aware, developing
goals and moving towards them.”

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2025 Medicines from the Earth Resilience - Boardwine

Resilient
Rising Appalachia
Leah Song & Chloe Smith

I am resilient
I trust the movement
I negate the chaos
Uplift the negative
I'll show up at the table, again and again and again
I'll close my mouth and learn to listen
These times are poignant
The winds have shifted
It's all we can do
To stay uplifted
Pipelines through backyards
Wolves howlin out front
Yeah, I got my crew but truth is what I want
Realigned and on point
Power to the peaceful
Prayers to the waters
Women at the center
All vessels open to give and receive
Let's see the system brought down to it's knees
I'm made of thunder
I'm made of lightning
I'm made of dirt (yeah)
Made of the fine things
My father taught me that I'm a speck of dust
And this world was made for me
So let's go and try our luck
I got my roots down, down, down, down
Down, down, down, down, down, deep
I got my roots down, down, down, down
Down, down, down, down, down, deep
So what are we doing here? What has been done?
What are you gonna do about it when the world comes undone?
My voice feels tiny and I'm sure so does yours
But put us all together we make a mighty roar
I am resilient
I trust the movement
I negate the chaos
Uplift the negative
I'll show up at the table, again and again and again
I'll close my mouth and learn to listen

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2025 Medicines from the Earth Resilience - Boardwine

Herbs that Nourish Resilience:

As offered by “Common herbs for stress: The science and strategy of a Botanical Medicine
approach to self-care”, by Joshua Burns an NIH study reported in Pub Med:
Ashwagandha
“An ayurvedic herb, it is commonly used in formulas designed to attenuate the stress
hormone cortisol. Ashwagandha lowers circulating glucocorticoids cortisol and
corticosterone through alteration of the Hypothalamic-pituitary-adrenal (HPA) axis,
ameliorating stress symptoms…. Ashwagandha's effectiveness as a stress reduction
therapy should be measured for its ability to reduce perceived stress, and not just a
decrease plasma cortisol.”
Rhodiola
Commonly used for fatigue, anxiety, depressions, physical and mental performance.
Neuro-protective benefits help protect against stress and keep the dopamine around
longer. “These studies lend significant evidence to the ability of rhodiola to mitigate the
stress response and reduce symptoms of burnout”.
Passion Flower
“Passionflower has been studied to determine the effects of the plant on mental stress and
related disorders such as anxiety. While included studies were limited, the authors
concluded that passionflower was an effective method of treating stress reactivity,
anxiety and insomnia. The mechanism of action of the herb is not fully identified… Most
current research looks predominately on the GABAergic mechanisms with relation to its
anxiolytic effects, with one article showing an affinity for acting on the hippocampus,
which has been shown as a potential target area for stress reduction.”
Lavender
“A 2016 study examining the mechanisms for Lavender aromatherapy found no effect on
the HPA axis, but measurable changes in Chromogranin A (CgA), an indicator for
catecholamine levels, demonstrating a potential effect on the acute stress response via the
sympathoadrenal medullary (SAM) pathway. Another study examining lavender
aromatherapy during sleep, showed an increase in activity in the temporal lobe and
increased delta-waves, which are associated with deep sleep, in the lavender group.”

Janet Kent & Roger Peet ‘s zine, Under Pressure: Herbs For Resilience, states,
“In physics, resilience is the word used to describe the ability of a body to withstand stress. For
us, resilience means the capacity to recover from or adjust to misfortune or change. This guide to
twelve plants that can help increase or enhance resilience in times of upheaval and uncertainty
includes essays about the physiology of stress…” Please have a look at the original text for more
information as to how they see these plants as enhancers of resilience.
Ashwagandha Milky Oats
Holy Basil Wood Betony
Reishi Lavender
Blue Vervain St. John’s wort
Hawthorn Rose
Motherwort Sage

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2025 Medicines from the Earth Resilience - Boardwine

Build Resilience Protocols

Agrimony Agrimonia eupatoria
Ashwagandha Withania somnifera
Astragalus Astragalus membranaceus
Bacopa Bacopa monnieri
Borage Borago officinalis
Cayenne Capsicum annuum
Chamomile Matricaria chamomilla
Cinnamon Cinnamomum verum
Cordyceps Cordyceps sinensis
Eleuthero Eleutherococcus senticosus
Ginger Zingiber officinale
Ginkgo Ginkgo biloba
Gotu Kola Centella asiatica
Hawthorn Crataegus oxyacantha
Hibiscus Hibiscus sabdariffa
Holy Basil Ocimum tnuiflorum
Lavender Lavandula angustifolia
Lemon Balm Melissa officinalis
Linden Tilia argentum
Mimosa Albizia julibrissin
Motherwort Leonurus cardiaca
Nettle Urtica dioica
Oats Avena sativa
Panax Panax quinquefolius
Passion flower Passiflora incarnata
Rehmannia Rehmannia glutinosa
Reishi Ganoderma lucidum
Schisandra Schisandra chinensis
Skullcap Scutellaria laterifolia
Turmeric Curcuma longa
Wood Betony Stachys officinalis
Yarrow Achillea millefolium

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2025 Medicines from the Earth Resilience - Boardwine

Herbal Formulas for Building Resilience

Moving Forward – Flight

Made as a chai tea, or brandy extracted elixir to sip, warm and move
Cordyceps
Turmeric
Ginger
Cardamom
Cinnamon

Facing Adversity – Fight

Deeply nourish and build vitality to kick butt as needed
Ginseng
Ashwagandha
Reishi
Cayenne

Overcoming Overwhelm – Freeze

Acknowledge the depth of self-preservation with drops of this as tincture to preserve stillness and allow
one to recalibrate:
Reishi
Skullcap
Vervain
Yarrow

Flow not Fawn

A mental and emotional support tea
Agrimony
Passion Flower
Ginkgo
Nettles

Creating Fortitude Deep Within

Decoction of the adaptogens, simmered until black and strained. Molasses added (2oz. to 1 cup)
will fortify your depleted yin, restore vitality and nourish your adrenals.
Eleuthero
Astragalus
Schisandra
Rehmannia

Empowering Belief, “I can”

Create a tea to accentuate the positive. Equal parts tea blend. 3 T./1 qt. Steep 20 min.
Holy Basil
Wood Betony
Gotu Kola
Borage
Nettle

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2025 Medicines from the Earth Resilience - Boardwine

“I am” Blessed
Herb tea made as an infusion to lighten and brighten your day
Lemon Balm
Damiana
Calendula blossoms
Rose petals - pinch

Reset the Polyvagal Nerve tincture

Combine 30 ml. each in 4 ounce dropper bottle. Dose with half stopper regularly when nervous,
overwhelmed and/or dysregulated.
Skullcap
Vervain
Motherwort
Oats, milky stage

Return to Joy Glycerite

Extract the herbal blend in vegetable glycerin and water combination: 60/40 using a warm bath to quicken
and extracting process. Strain, bottle, lable and take in drops throughout the day.
Hawthorn
Lemon Balm
Rose
Mimosa
Hibiscus

Trauma Release Herbal Tea

Combine the dry herbs and store in a jar to be able to make this tea often. 1 T/ 1c
1 oz Holy Basil
1 oz Passion flower
.5 Lavender
.1 Rose

Nourishing Resilience BonBon

To make a bonbon just mix the wet ingredients together in a bowl, then add the powders. If you need
more liquid you can add honey or coconut oil melted. Mix together and roll in the chocolate chips, nuts
and coconut if you like.
Eat 1- 3 a day with sheer pleasure and deeply nourish yourself and build resilience.
1c Peanut Butter, crunchy
2T Honey
1T Coconut oil
¼c Oats, rolled or quick
1T Eleuthero powder
1T Astragalus powder
1T Reishi mushroom powder
½c Chocolate chips

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2025 Medicines from the Earth Resilience - Boardwine

7 C’s of Resilience tincture

Combine 35 ml. of each herb into an 8 oz / 240ml bottle. This tonic can be taken daily
to boost resilience through herbs paired with leadership qualities as identified by Anne Koopman: A daily
dose could be 1 t. AM and PM during stressful periods.
Competence Gotu Kola
Confidence Borage
Connection Chamomile
Character Holy Basil
Contribution Nettle
Coping Skullcap
Control Yarrow

Herbalists who practice and support Resilience

Through offering a free clinic to our community, Green Comfort School of Herbal Medicine
serves to allow access to herbal health care. Clients are heard, offered clinical plan of care and in
some cases herbs, herbal teas and remedies are available free or on a sliding scale. We are
trauma informed care givers and chose to educate ourselves in harm reduction as we bridge the
conventional health system with the traditional food and herbs as medicine way. Through
teaching herbal wisdom and science, we match herbs to the constitution, physiology and desired
outcome as we build formulas which are made personalized for each individual. This provides
us an opportunity to include herbs to nourish resilience.

As Colleen at Wild Roots Apothecary says, “Use your herbs to set boundaries, breath to resettle,
create positive escapes and enjoy copious amounts of Lemon Balm tea.”

Through acts of reciprocity and resilience herbalists participate in creating calm and order out of
chaos. This requires us to use our tools and resources to accept help and foster community. Our
hope is to build a resilient community utilizing these goals of community mutual aid and more
active home apothecaries.
It is my hope that some of the goals, considerations and many of the recipes can be used to put
into action by the continued grass roots effort of the Mutual Aid movement.

We want to make an honorable mention for many who participated in the resource sharing,
accepting donations, making medicine and distributing the herbal products for those in need. We
also want to acknowledge the many hours spent on the part of those who gathered herbs and
supplies to distribute medicine and meet community to offer clinical support. Thank you for
these and many other Apothecaries nationwide who are generously donating to disaster relief:

Herbal Mutual Aid Directory

Herbalista & Mutual Aid

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2025 Medicines from the Earth Resilience - Boardwine

Abby Artemisia, The Wander School

Rebecca Buyer
Appalachian Herb Collective
Twin Flower Botanicals;
Earth Haven Eco Village; Dr. Monique Massal
Red Moon Herbs; Jeannie Dunn
7Song Herbal First Aid
Rising Appalachia
Blue Ridge School of Herbal Medicine
Smile Herb Shop
Strob Apothecary
Sacred Plant Traditions and Botanic Mobile Clinic, Kat Maier
Terra Sylva School of Botanical Medicine; Dave Meesters, Janet Kent, Jen Stovall

References And Resources:

1. Webster dictionary, resilience

2. The American Psychological Association

3. Nina Flagler Hall Medium.com Mar 20, 2019 Blog https://medium.com/nemac-

blog/its-resilience-not-resiliency-56c9e2d65792#id_token=
UNC Asheville’s National Environmental Modeling and Analysis Center (NEMAC)

4. Anne Koopmann of Lead Like You, The Courageous Leadership podcast

www.annekoopmann.com & https://annekoopmann.com/podcast/
The 7 C’s of Resilience for Leaders.

5. Nicole Rose; https://solidarityapothecary.org/ https://solidarityapothecary.org/podcast/

Frontline Herbalism Podcast, Herbalism & State Violence book
6. https://pmc.ncbi.nlm.nih.gov/articles/PMC9737923/ “Common herbs for stress: The science and
strategy of a Botanical Medicine approach to self-care”, Joshua Burns

7. Bouncing up: The development of women leaders’ Resilience

Stephanie Duchek a 1, Charlotte Foerster b 2, Ianina Scheuch c 3
Center for Responsible Research and Innovation, Fraunhofer Institute of
Industrial Engineering IAO, Germany

8. Bob Sternfels, Global Managing Partner at Mckinsey and Co. World Economic Forum in
Davos, Switzerland, 2024.

9. Garmezy,1974; Werner, 1989; Werner & Smith, 1982

10. Luthar & Cicchetti, 2000; Wright et al., 2013

11. Janet Kent & Roger Peet, Under Pressure: Herbs For Resilience, May 2023.
https://justseeds.org/product/under-pressure-herbs-for-resilience-zine/

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2025 Medicines from the Earth Resilience - Boardwine

12. Herbal Mutual Aid Directory https://bit.ly/herbal-mutual-aid-directory

https://docs.google.com/document/
mutualaidherbs@gmail.com.

13. Herbalista https://herbalista.org/

The good news is that joy ~

collected over time
fuels resilience ~
Ensuring we’ll have reservoirs
of emotional strength
when hard things do happen.

Brene Brown

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2025 Medicines from the Earth Non-Alcohol Extractions - Boardwine

Non Alcohol Herbal Extractions

Vinegar, Honey, Glycerin & Oil

Teresa Boardwine, RH (AHG)

This presentation will explore effective non-alcoholic herbal extraction methods—using

vinegar, honey, glycerin, and oils—as alternatives to traditional tinctures. These
preparations offer versatile options for people with alcohol sensitivities, children, and
those who seek more food-based remedies. We will include formulation strategies,
dosing guidelines, and demonstrate preparation techniques. Emphasis will be placed on
safety, efficacy, accessibility and integration into family and community apothecaries.

By exploring different solvents and carriers - such as vinegar, honey, glycerin, oil, and
nut butters— we can make herbal remedies both palatable and effective.
We’ll explore several alcohol-free delivery methods and recipes. You’re encouraged to
experiment with the ingredients and techniques presented. The goal is to craft
enjoyable, supportive herbal products without the use of alcohol.

Vinegar as menstruum
Vin Aigre, two French words denoting sour wine is where the Vinegar is derived.
Vinegar made with naturally fermented apples, Apple Cider Vinegar (ACV), can be used
as a solvent. ACV also provides its own medicinal benefits, such as; it balances PH,
astringes the skin and tones mucus membranes. It is a refrigerant, a thirst quencher and
a sialagogue that promotes saliva. Vinegar is also used to stimulate the secretions of
the kidneys and respiratory mucous membranes.
Vinegar by FDA standards must contain at least 4% acetic acid per 100cc. It is only 4-
6% acid solution but is stable at room temperature.
It contains the fruit’s inherent mineral salts, specifically Potassium.
Dr. William Cook a brilliant herbalist, physician and professor - wrote the Physio-Medical
Dispensatory of 1869, where he so eloquently wrote about Lobelia. He suggests that
Lobelia is best extracted into vinegar and I do too. Other Alkaloid-containing plants,
such as, Goldenseal and Bloodroot are also best prepared in vinegar. Cayenne also.
Because of the acid content it is best to use dried plant marc in this menstruum to have
a more shelf-life stable product.
Medicinally, vinegar makes an excellent gargle for sore throats.
As a menstruum it is useful to extract fresh mineral rich herbs to be used as food and
medicine:
Motherwort
Mugwort
Dandelion
Shiitake mushroom
Nettle
Violets

Cayenne/Sage Throat Gargle

Sage tea

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2025 Medicines from the Earth Non-Alcohol Extractions - Boardwine

ACV
Cayenne pepper powder
Salt

Fire Cider Vinegar

½ c Onion
½ c Garlic
½ c Ginger
½ c Horseradish root
¼t Cayenne powder
1 Parsley bunch
1 qt. Apple Cider Vinegar

Oxymels- A preparation using both apple cider vinegar and honey as menstruum,
making it sweet and sour. Unpleasant tasting herbs may be disguised by this method of
preparation. First the herbs are simmered in the vinegar then strained and honey is
added to the liquid for sweetness, medicinal properties and stability.
An oxymel is usually comprised of 2 parts vinegar to 1 part honey.
The typical dosage is 2 T or 1 oz. of the oxymel. This is an excellent way to ingest food
source Phyto-nutrients.
Medicinal culinary herbs which make an excellent oxymel include:
Onion, Garlic, Sage, Oregano, Thyme, Basil, Ginger
For the real medicinal ones which are mor difficult to ingest try: Elecampane,
Horehound, Hyssop, Mullein, Marshmallow together for a lung clearing oxymel.

Vir-Oxymel-
1 large Raw onion, sliced
Hands-full of my favorite garden raised culinary essentials:
Rosemary, Sage, Thyme and Oregano
32 oz. Apple Cider Vinegar
Add onion and herbs into a soup pot.
Pour vinegar over them in the saucepan.
Cover with a lid and bring up heat slowly to a simmer.
Lower heat if necessary and infuse for 30 minutes.
Strain through a sieve into a large measuring cup.
Measure out 2 cups, add to a quart jar.
Honey - Measure out 1 cup and add while the liquid is still warm, not hot.
Mix well, Enjoy.
Refrigerate as desired.
Dose is 1 t. – 1 T often when an illness is present.
May be used as salad dressing or over cooked greens.
For cold and flu symptoms add a tablespoon to warm water and drink as a tea.
Dr. Duke’s Viroxymel – original formula based on the anti-viral properties of these
plants. Have fun creating your own, inspired by the “Duke of Herbs”.
garlic, ginger, green tea, licorice, onion, persimmon, and turmeric

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2025 Medicines from the Earth Non-Alcohol Extractions - Boardwine

Honey-
Wonderfully healing and nutritious food of the bees. This enzyme rich anti-bacterial
carries the pollen of whatever the bees are eating which makes it valuable in the
treatment of allergies. There are many ways to use this delightful food for healing. I find
it extremely beneficial for sore throats. It also alleviates cough and helps one recover
from a chest cold.
Honey has a high osmotic pressure which helps it draw out toxins and reinvigorate the
skin when used as a mask.
Honey is also used externally to heal skin after a burn or a rash.
Honey is the only food on the planet that will not spoil or rot. However, when left in a
cool dark place for a long time it will "crystallize” or turn to sugar. To re-liquefy loosen
the lid, boil some water, and sit the honey container in the hot water bath, off the heat,
careful not to boil. Heating honey kills the enzymes.
Remember to buy local honey if at all possible.

Ginger Honey syrup

1 c. Ginger root fresh, chopped lengthwise to fill a pint jar
2 c. Honey to cover
1 t. Lemon zest (optional)
This is the best honey ever! I use a wide mouth pint jar for this one. Just fill a jar with
fresh ginger, peeled and cut lengthwise. Pour on the honey until you reach the top of
the jar making sure all the ginger is covered. The honey begins to extract the juice from
the ginger immediately. I turn the jar upside down several times a day. It only takes
days before the jar is full of liquid the viscosity of syrup. The honey is ready to be
poured off.
Save the ginger! It can be used in teas or in scones, in stir-fry or for nibbling.
I save it for several days in a container in the refrigerator, eating some daily.
To the ginger honey you may add lemon zest and allow it macerate for a while.
This honey to a delicious pairing with Green Tea in the morning.

Spruce tip honey

Turmeric honey
Cinnamon honey

Glycerin makes lovely “Glycerites” or Glycol-extracts-

Vegetable glycerin, food grade and organic is a wonderful sweet viscous menstruum.
Glycerin is a solvent, a preservative and an emollient.
It is the sweet principle of oils, obtained by the hydrolysis of vegetable or animal fats.
The vegetable glycerin I use is extracted from coconut fat.

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2025 Medicines from the Earth Non-Alcohol Extractions - Boardwine

Here are some guidelines to follow when using vegetable glycerin in herbal medicine
making:
Glycerin needs to have water to break the chains for extracting dry plants.
To preserve an herbal extract, use 25% glycerin to stabilize a decoction to create a
syrup, which will be stable for 3-6 weeks makes a tincture which will last for 2 years.
Adding 10 % glycerin in an alcohol extract will keep tannins in suspension.
Use a ratio of glycerin/water: 80% glycerin 20% water
Some herbalists recommend a 60/40 or 70/30 ratio glycerin to water.

I will use these the 80/20 ratio to make some glycerite extracts.
For 10 ounces of menstruum use:
8 oz. Vegetable glycerin
2 oz. Water
Measure glycerin first. Add the water. Notice the water does not penetrate the
glycerin. Mix together with a fork to break the chain and incorporate.
Cover the herb in the solution.
Shake, Stir and Warm ever so slightly to extract.
Hot water bath indirectly to warm infuse the glycerin water solution into the marc.
If it warms for 2-4 days I taste it to check if it is appropriately extracted.
Strain through a stainless steel strainer, pushing with a spoon through a tight
weave. Pour into a glass bottle using a stainless funnel.
Herbs to prepare as a glycerite:
Cinnamon
Lavender
Hibiscus
Chamomile
Fennel
Rose Glycerite
Holy Basil
Oats

Mind Body Spirit glycerite:

Holy Basil
Oats
Rose

Oil infusions-
Olive oil Olea pinguia, a non-volatile, fixed oil rich in anti-oxidant tocopherols.
Vegetable, nut and seed oils are fixed fluid substances, soluble in chloroform, ether or
other fats. Fats extract or dissolve fats, making them perfect for the fatty acids we want
to extract from highly resinous plants fat soluble phytochemicals.

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2025 Medicines from the Earth Non-Alcohol Extractions - Boardwine

Using a fixed vegetable oil to extract plant properties and keep them stable is one way
oil can be used in making medicine. Oil extractions may be ingested, applied on the
body externally or made into salves, balms and body butters.

Rosemary & Garlic infused Olive oil-

Garlic bulb divided into cloves and paper peeled or better yet, fresh from your
garden, washed and chopped.
Harvest 6-8 springs of Rosemary the length of the jar.
Fill a wide mouth pint jar with garlic and rosemary.
Pour olive oil over top to cover plant matter.
Allow this oil to sit on a warm surface for a week or so.
Strain well. Stabilize the oil using 10 drops of Vitamin E oil.

Oils for external use include:

Rosemary infused in Olive oil- for hair and head, rub into scalp and massage.
Mullein ear oil- used in ears for ear aches, inflamed ears and blockages
St. John’s wort flower oil- to reduce nerve inflammation like sciatica, neuritis and any
herpes or shingles out breaks.
Chickweed oil for soothing inflamed skin
Solomon’s seal root – as anti-inflammatory rub for hands, hips and shoulders.
Black Cohosh root oil – for neck, knees and join rub.

Ghee
Clarified butter is stable at room temperature. Ayurvedic medicine uses it as a carrier of
medicinal herbs particularly those, which are fat-soluble. Ghee is excellent for diseases
of the subtle tissues, nerves and mind, including many Vata problems and is said to
help reduce fever. Medicated ghee in Ayurvedic medicine is called Siddha Ghrita.
Some herbs prepared in ghee include:
Ashwagandha
Garlic
Gotu Kola
Bacopa
Licorice
Shatavari
Triphala

Bonus Recipes for Non-alcohol Medicinal Foods:

Sunny Day BonBon

½ c Sunflower seed butter
2T Ghee
2T Shatavari
1T Ashwagandha

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2025 Medicines from the Earth Non-Alcohol Extractions - Boardwine

1T Licorice
½c Sunflower seeds to roll them in

Adrenal Gland Adaptogen Molasses Brew

1 oz Ashwagandha
1 oz Astragalus
.5 oz Rehmannia
6 c water
½ - 1 c Molasses
Brandy is optional, add for longevity of the syrup.
Weigh and Measure adding everything but the molasses into the soup pot
Bring to a simmer and leave off the lid. Reduce the water by half as it simmers.
Strain out the herbs. You should have about 3 cups by now.
Add ½ cup of the black strap molasses and stir. Sip for taste. It should be strong
tasting. If you want more of the molasses minerals (iron and calcium) add more while it
is warm.
I have been skipping the Brandy for stabilizer by warm bath canning the product to
create a seal in the pint size canning jars.
Take 1 T. twice a day to increase vim, vigor and vitality.

Slippery Elm Oatmeal Gruel

¼ c Slippery Elm powder
½t Cinnamon Powder
2T Oatmeal
1c Water
Slowly heat and stir. Let cool, sweeten with honey if you like.

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2025 Medicines from the Earth Fungi Medicine - Chimelski

Fungi Medicines in Clinical Practice

1.Universal Benefits
2.TCM Energetics & Indications
3.Extraction Methods
4.Constituents we care about
5.Food as Medicine
6.Materia Medica
7.Clinical Pearls

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 2025 Medicines from the Earth Fungi Medicine - Chimelski

Mushroom Medicine Details

Variables that influence the outcomes

How are they grown and harvested?

• Wild foraged, grown indoors, grown outdoors
• Substrate- logs, grain, grow tanks/jars?
• Will influence some constituents/nutrition.
• Mushroom products widely used, shipped to and from many
countries/different standards

Mushroom Medicine Details

Variables that influence the outcomes

• What part of the mushroom is it?

• What life stage? Fruiting Body: Mycelium:
What has always classically been used: the ethnobotany, TCM
Typically grown on grain, oats, corn etc

• Fruiting Body or Mycelium? and traditional use/ foundation we build on.

Most research research is on the fruiting bodies; more now on
Less investment, faster & easier grow in masses, faster turnover.
Typically less active compounds- up to 50% less beta-glucans than

• If mycelium, what kind…

mycelium
fruiting bodies 50-80% starch from the growing substrate—
Active, “full spectrum” More active constituents- beta-glucans,
I think of it as a fermented food such as tempeh- still has nutritional value
antioxidants, triterpenes, minerals (phosphorus, copper, zinc,
but not as much of the strong medicinal actions
potassium); vitamins (C, D, beta-carotene, Bs). * one known
Pure mycelium extracts grown in liquid fermentation tanks to get
exception is erinacine A in lions mane mycelium [hericenones C &D in
mycelium without growth substrate
fruiting body]
Potential for different beneficial components, enzymes higher etc,
North spore graphic

we just do not know all those constituents yet. More and more research
is being done. Likely a great medicines too, but different. Use combos if anything.

Mushroom Medicine Details Mushroom Extraction

Variables that influence the outcomes
3. How is it prepared? What end product is being ingested?
Hot
• Products prepared from fresh mushrooms vs. dry mushrooms
Water Soluble Alcohol Soluble
Beta- Glucans Triterpenes
• Eating fresh- raw vs. cooked. i.e. raw powder will have poor absorption
• Dried raw powder vs concentrates and extracted powders.
• Alcohol extraction, Glycerin
• Hot water extraction, teas, broths etc. Cordyceps
Reishi- ganoderic acids
• Double Extraction
Lions Mane
Chaga- inotodiol
4. Standardization: Turkey Tail
Whole mushrooms or isolated constituents?
Shiitake
There are so many compounds we do not even know yet in fungi, synergy of whole mushroom
medicine is important to preserve best outcomes. Can test to see % desired constituents, but should Maitake When looking for triterpene rich extracts, mushrooms need
not just use isolated constituents be extracted in alcohol, so DUAL extracts are desired for beta
5. Advanced Extraction methods:
glucan immune actions and triterpenes.
Are the smaller pieces of heteroglucans as active as we hope?
Alcohol, heat, Hcl all reduce the size of the initial compounds, potentially making them less active the more they are
Others, even if done via the dual extract method, the beta
broken down by these methods. Less is more.
glucan content can be deceased with no need bc no (known)
6. Goals, dose, duration, scope, population targeted.
active triterpenes.

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Choosing Potent
Mushroom
DOUBLE EXTRACTION Method Mushroom Medicines
the need to knows

Water Soluble Alcohol Soluble FRUITING BODIES

Beta- Glucans Triterpenes More active beta glucans
What has always been traditionally used
Mycelium can be 50-80% grains
1. Mushrooms first alcohol extract tincture for 4 weeks
EXTRACTED POWDER > Raw
2. Strain and save the tincture Raw powders use hot water extraction at least -
3. Save the mushroom mark and simmer on low heat for 2 hours, strain make tea, soup etc due to chitin
4. Combine with the tincture = Double extract DOUBLE EXTRACTION “best” in simple terms
to get both alcohol and water soluble constituents
• Dual extracts can end with lower beta-glucans that water extracts bc they can condense out in the alcohol and end up
BETA GLUCANS- hot water soluble
being strained out with the solids, so if you are looking for high beta-glucans, hot water extract is still the best method.
TRITERPENOIDS- alcohol
Hot water extracted powders, where the water is evaporated off, leaving condensed solids are the best options.
• Hot water extraction dissolves the indigestible fiber (chitin), the extracts can then be strained allowing the fiber to be DOSE- Whole mushroom/powder doses range from
removed from the extract when the water is removed. Or can be processed into a powder and the indigestible fiber can 2 to 16 to 50 grams in divided daily doses. At least 6g
serve as a prebiotic in most for therapeutic Chinese Pharmacopoeia Doses

Nutritional Powerhouse

Mushroom Medicine as food.

Cook Your Mushrooms!

Heat, water, salt, fat etc all help to break down
the chitin, to exposes active molecules

ALWAYS cook your mushrooms for better

absorption of active constituents and
Generalized Benefits of Medicinal Mushrooms nutrients.
mostly via the b-glucans and antioxidants which are present in all Tastes better too! Uncooked more likely to have issues
with contamination and some causes dermatitis, i.e.
• Heart disease- balancing lipids, inflammation and oxidation
• Immune system balance But if the health and taste benefits of cooked aren’t enough for you…
• Acute or chronic, prevention, palliative or targeted immune and cancer therapies Shiitake flagellate Dermatitis
• Liver support- detoxification support, tissue healing, antiviral (hepatitis), can help the burden of • Rare skin eruption
• resembles whiplash marks
many medications on the liver • occurs after consumption of raw
• Digestive health & healing inflamed digestive tissues shiitake
• Reaction to lentinan, a thermolabil
• Skin health- yin/moisture building, antioxidant, detoxication/liver/digestion polysaccharide which decomposes
• Many have anti-diabetic, anti-obesity and blood sugar balancing actions too upon heating
• linearly arranged erythematous,
pruritic papules on trunk, limbs
• Usually self-limited, resolving within
10 days of onset.

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COOKING MUSHROOMS QUICK TIPS

IF YOU CAN DO NOT WASH, WIPE WITH
WET TOWEL OR BRUSH OFF DIRT WITH
FINGERS, WATER MAKES THEM DAMP AND
HAVE TO COOK FOR LONGER

HIGH HEAT CAST IRON, SALT, LET THEM

SWEAT OUT THE MOISTURE TO AVOID
CHEWY TEXTURE PEOPLE DON’T LIKE.

THEN ADD YOUR GARLIC OR OLIVE OIL,

ONION OR GARLIC ETC

CAN ALSO MARINATE AND BAKE, GRILL

OR SAUTEE

LIONS MANE “CRAB” CAKES

AWESOME IN SOUPS

= 5-10 grams of
BAKING! LIONS MANE- MORE shiitakes daily
MILD AND TASTY, GOES WELL
IN OATS OR BAKED GOODS , to improve
REISHI PAIRS WELL WITH immune health
CHOCOLATE - BROWNIES,
BANANA BREAD, PANCAKES etc

TIMING OF THE DIFFERENT 52 healthy adults

MUSHROOMS- oysters and 5 or 10 g of mushrooms daily for
softies add to the pan 4 weeks.
towards the end = improved immune cell counts
Reduced CRP, inflammation
Shred with your fingers for
nice texture- lions mane,
maitake, oysters, chicken
of the woods etc

Pizza, mushroom veggie

burgers, grilled cheeses
-esp over a campfire with Fresh Mushrooms
~ 90% water
freshly foraged finds!
Versus some 500 mg raw 141 g
cap of myceliated oats
28 g

Potentize Your Medicine& Celebrate Plant

Mushroom Synergy with Cacao Constituents we care about
Anandamide: the “bliss” neurotransmitter, influences stress response and pain regulation. It binds to cannabinoid and opiate receptors. In
studies where it is blocked from binding in the CNS, we see a worsened stress response. It may also bind to some Vanilloid Receptors, potentially
mitigating conditioned fear responses and the lasting negative effects to prevent emotionally crippling long term, ptsd reactions. Originates from
the sanskrit “ananda,” which roughly translates to “bliss” or “joy”.
5HT Serotonin: major hormone that stabilizes our mood, feelings of well-being, and happiness. Serotonin has impacts your entire body, nerve
communication, digestive action (peristalsis), eating, sleeping and more. Major target of most antidepressants, SSRIs = Selective Serotonin
Reuptake Inhibitors- Lexapro, Prozac, Zoloft just to name a few.
Tryptophan: Building block of serotonin and melatonin, influencing mood, attention, cognition, memory, behavior and sleep-wake cycle.
Magnesium: essential mineral super-relaxor of muscles and mind. Cofactor and building block of countless reactions in the
body but also wonderful for physically relaxing muscles spasms and mentally relaxing to help with sleep, constipation and stress response.
Flavonoids, Polyphenols, Tannins & Catechins: Antioxidants supreme
PEA: is an alkaloid that acts as a neuromodulator. Beta-phenethylamine is pharmacologically similar to Theobroma cacao
amphetamine, with a similar but much more mild and shorter acting psychoactive effect. PEA can have an
antidepressant action [cool human trial PMID: 9081552], pain modulating actions and is known to be one of many
neurotransmitters influencing feelings of love, attachment and connection. PEA also initiates the release of beta-
endorphins, endogenous opioid neuropeptides related to pleasure. PEA is high in those who consistently run and
do moderate exercise, showing its relation to the classic “runners high”. On the other side, PEA tends to be lower in
those who are depressed.
Manganese plays a role in balancing cholesterol and glucose and influences heart, brain, blood and bone health.
Iron: super source for our vegetarians! One of the highest plant sources, almost double the amount per 100g of
spinach (3.6mg) to cacao (7.3mg).
Additional Minerals & trace minerals:, calcium, iron, zinc, copper, potassium, chromium and
molybdenum too. Also protein, lipids (fats), and small amounts of carbohydrates.

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Con!ituents we care ab"t

Psilocybin
• Psilocybin and psilocin, indolealkylamines, are structurally similar
• to the neurotransmitter serotonin (5-hydroxytryptamine or 5-HT).
• Psilocin mainly interacts with 5-HT1A, 5-HT2A and 5-HT2C receptor
subtypes: a mixed receptor agonist.
• Unlike MDMA, Psilocybe do not just flood the brain with
serotonin. They target a specific subtype of serotonin receptor—the
5-HT2A receptor—to which they bind directly, thereby activating it/
• The 5-HT2A receptor is known to play a key role in regulating
mood, anxiety, schizophrenia, trauma processing, PTSD, joy,
creativity and consciousness

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Hot gossip- White button, Cremini, Portobello are all the same species
Auricularia (auricula-judae, polytricha, spp.)
Wood Ear, Jelly Ear, Mu-err Caution: blood thinning “szechwan purpura”

Agaricus bisporus
Cloud ear, jelly fungus, anticoagulant effect. In 1980, a U.S. case of “Szechwan Purpura” was reported in the New
England Journal of Medicine. A 32-year-old U.S. researcher (during an experiment using his own
Black Fungus, Tree jelly fish blood platelets for clotting) found after some 50 trials one morning that his platelets would not
agglutinate or release serotonin on exposure to epinephrine. It continued to inhibit platelet
response in the researcher and other volunteers for 3-24 days. Like aspirin (or other platelet
inhibitors) this mushroom should not be ingested prior to surgery or in patients with

White: fresh, young; common, inexpensive, champignon poor blood clotting.

Cremini/ Baby Bella: brown strain of button mushroom &

Traditional Chinese Medicine ⍾ Used in TCM cooking as early as 300-200BC.
immature Portobello, chestnut brown
⍾ Flavor & Energetics: sweet, neutral; lung, stomach, liver, spleen, kidney, large intestine meridians.
Portobello: fully mature, thick, meaty texture; Campellone ⍾ Actions: nourishes yin and moisturizes, replenishes qi, revives blood, gently cools to stop bleeding, moistens and
mushroom, roman mushroom clears lung qi, build blood, build stomach qi, nourishing and moistening.
⍾ Indications: Dry cough, Urine with blood, metrorrhagia, hemorrhoids, blood deficiency.

⍾ Heart disease & circulation balancing, Anti-coagulant, Balances cholesterol

⍾ Hypoglycemic, Hepatoprotective, Antiviral, Anti-tumor
⍾ Healthy Aging, Skin Beauty tonic
⍾ Anti-inflammatory for skin, mucus and eyes
⍾ Vitamins: B1, B2, B5 (40% RDA in 100g raw mushroom), B6, B9. Minerals: Copper, Iron, Magnesium,
Selenium, Zinc, Fiber, protein, calcium, phosphorus.
⍾ Asian culinary staple- adds consistency/texture/crunch more than flavor.
⍾ Contains lecithin for lipid cell membrane health and oxidation. Linoleic acids, soluble fiber, antioxidants.

Saprophytic, deciduous wood-decaying (Maple, Oak,

Ash, European Elder). Found all year round.
Clusters gelatinous sporocarp fruiting body,
rubbery, flexible, fine surface hairs; edible

Auricularia polytricha Potential use in Alzheimer's and amyloid

plaque formation, helps stimulate the enzymes Cordyceps sinensis
that cleave or breaks down the plaques
Adaptogen, Energy Caterpillar fungus
Promoting, Anti-tumor, Himalayan Viagra
Anti-inflammatory, Lung, Immune, Adrenal affinity
Antioxidant,
Hepatoprotective

Classic Adapotogen: Improves energy, stamina, physical

Different species of cordyceps
performance and quality of life
Traditional Chinese Uses: Cough, chronic bronchitis, respiratory
dysfunctions, kidney disorders, frequent nocturia, male sexual
dysfunction, liver disease, dizziness, weakness, waisting and
opium addiction
Immunostimulating polysaccharide galactomannins, cordycepic acid.
Amino Acids, Fatty Acids, Polyamines, Ecdysterones, Adenosine, B-
Vitamins, polysaccharides, ophiocordin (an antibiotic compound),
cordycepin, cordypyridones, nucleosides, bioxanthracenes, sterols,
alkenoic acids, and exo-polymers.

CORDYCEPS Forms of Cordyceps

More behind its common name: Himalayan Viagra.
Cordyceps sinensis Almost all of the supplements are not true cordyceps sinensis bc of its extremely high price-
wild cordyceps costs up to $20,000 per kilogram; rarely even sold in North America.
People often speculate or laugh while asking, who was the first one who figured out that _____
herb worked for this ____problem? One of the key ways- is through our animal teachers, by close ⍾ Cordyceps Cs-4. Cordyceps sinensis is difficult to grow in the lab or on different substrates, still
observations of nature's patterns and super tuned in animal stewards. not really affordably cultivated to this day. In the 1980s, scientists made Cordyceps anamorphs, mycelium
growth that are unable to produce a mushroom fruiting body.
As the story goes, local herders observed that the yak, goat and sheep
Using liquid fermentation, these anamorphs were grown to create mass amounts of pure mycelium (this method uses a
who ate C. Sinensis while forest grazing became very strong and
liquid culture mycelium or liquid fermentation nutrients which are then removed, leaving the pure mycelium). These
stout. They then began adding the powdered fungus to their jaggery A few examples of how local Himalayan anamorphs were studied extensively and found to produce similar results to the wild Cordyceps sinensis —
feed( cane juice and often date or palm sap) to increase milk healers still use it now, for all genders > now known as Cordyceps Cs-4. Many clinical trials in China, the Chinese government approved its use in
production, reproductive capacity and livestock vitality. They then felt -1 piece with a cup of milk for sexual potency
TCM hospitals and is recognized as a safe natural product drug. If a Cordyceps supplement is claiming to
and desire
confident in its safety and efficacy and began ingesting it be Cordyceps sinensis and it is made in China, it is almost always Cordyceps Cs-4.
- 1 piece in 1 cup chang (local alcohol) or hot
themselves. [animal trials are not just a “modern” science marvel]. water, leave for 1 hour and drink in the
morning and evening as a tonic (Bhutia
Word of mouth spread fast about this potent vigor and vitality communities)
- Mixed with ginseng for cancers
enhancing mushroom, especially because of its reproductive -Prolonged, continuous use by local folk
and aphrodisiac actions. It became an honorable gift to give to healers/traditional healers for the treatment
relatives to promote the family’s vitality, used as a wedding of 21 ailments, including cancer, bronchial
Cordyceps
asthma, bronchitis, TB, diabetes, cough and
gift etc. Traditionally, they would collect the aerial fruiting myceliated
Cordyceps militaris.
cold, erectile dysfunction, BHP, jaundice,
body/stroma and dried it in the sunlight. alcoholic hepatitis, etc., were noted. Cordyceps sinensis CS4 liquid grow tanks
grain
PMID: 21731381
Cordyceps species that can be commercially cultivated at scale to produce a
mushroom (fruiting body); becoming quite popular. Tests on par with sinensis.
Made from the mushroom fruit body= higher levels of the important beta-glucans.

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Cordyceps militaris Mushrooms turned into important pharmaceutical drugs:

& balancing auto-immunity

Cordyceps subsessilis, the cyclosporin fungus

asexual state of C. subsessilis is a white mold
called Tolypocladium inflatum

produces cyclosporin, an immunosuppressant drug used following organ transplantation

• prevents the body from rejecting foreign tissues
• acts to suppress the production of certain types of white blood cells (T-helper cells and T-suppressor cells)
• Prevents expression of interleukins, all of which are involved in the body's ability to recognize and
defend against foreign

= mushrooms can be beneficial in balancing autoimmune conditions

Cool article one this: https://news.cornell.edu/stories/1996/09/cyclosporin-molds-sexual-state-found-new-york-forest-cornell-students-discovery

Super antioxidant

RESULTS:
Cellular senescence was unregulated by CSE
(cigarette smoke treatment
C. sinensis can decrease CSE-induced cellular
senescence.

Activation of ROS/PI3K/AKT/mTOR
signaling pathway was enhanced by
CSE treatment, and decreased when C.
sinensis was added.
20 adults, double blind placebo controlled
333mg TID or placebo for 12 weeks.
Blocking ROS/PI3K/AKT/mTOR signaling
Improved exercise performance & wellness
pathway can attenuate CSE-induced cellular
senescence.

Conclusion

CSE can induce cellular senescence in human

bronchial epithelial cells, and ROS/PI3K/AKT/mTOR
signaling pathway may play an important role in
this process. C. sinensis can inhibit the CSE-
induced senescence.

Cordyceps & Ischemic Brain Injury Ganoderma lucidum REISHI, Ling Zhi
Mushroom of spiritual potency
WIB801C, the standardized extract of Cordyceps militaris used to treat rats that had
had induced ischemic injuries (no blood flow to certain areas of the brain)
adaptogen, immune stimulant, antioxidant
WIB801C significantly decreased migration of cultured microglia/macrophages. This anti-chemotactic
activity of WIB-801C was not mediated via adenosine A3 receptors, although cordycepin, the major
⍾TCM: Tonifies Jing, Qi and Shen. calmness, centeredness,
ingredient of WIB801C, is known as an adenosine receptor agonist.
balance, inner awareness and inner strength.
Post-ischemic treatment with WIB801C significantly reduced the infiltration of ED-1-and ⍾Asia as a tonic herb consumed for the attainment of
MPO-positive inflammatory cells into ischemic lesions in tMCAO rats.
radiant health, longevity and spiritual attainment.
WIB801C-treated rats exhibited significantly decreased infarct volume and cerebral
edema, less white matter and blood-brain barrier damages, and improved ⍾ In the middle ages- used by mountain hermits, monks, Taoist
neurological deficits. adepts and spiritual seekers throughout Asia to help calm the mind,
ease tension, strengthen the nerves, strengthen memory, sharpen
WIB801C also improved survival rates over 34 days after ischemia onset. concentration, improve focus, build will power and, as a result, help
A significant reduction in infarct volume and neurobehavioral deficits by WIB801C build wisdom.
was also observed in rats subjected to pMCAO.
Called the "Mushroom of Spiritual Potency" by these seekers.
Conclusions: In summary, post-ischemic treatment of WIB801C reduced infiltration of
inflammatory cells into ischemic lesions via inhibition of chemotaxis, which confers long-lasting
⍾ Used to improve meditative practices and to protect the body,
histological and neurological protection in ischemic brain. WIB801C may be a promising anti-
mind and spirit so that the adept could attain both a long and
ischemic drug candidate with clinically relevant therapeutic time window and safety.
healthy life.

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Ganoderma lucidum Mushroom

REISHI, Ling Zhi
of spiritual potency
The Auspicious Fungus
adaptogen, immune stimulant, antioxidant Finding it was a blessing
Great luck/ very special / a gift
The spirits of the mountain favoring you
*AMPHOTERIC* = *BALANCING* Rituals & astrology to help find it
Mild tranquilizing central nervous system effect sleep. Sage naturalist would go into the mountains
Stress Response Adaptogen Carrying specific talismans
Immune potentiator “modulator, helps regulate the immune system A white chicken or a white dog to gain favor of the mountain spirits
Polysaccharides/Betaglucans strengthening overall immune functions
Ganoderic acids Reishi was such a sacred finding, that the mountain spirits would guard it.
inhibit histamine release, improve oxygen utilization, If you did not pay honor to them, they would not show you the reishi-
improve liver functions, You could walk right by it and not see it.
potent antioxidant free-radical scavengers.
VAST cancer research: breast, prostate, leukemia, liver, lung and more Only ones who could afford it were the emperors and wealthy
Cardiovascular, Cholesterol balance, Blood pressure Because it was so special, it is one of the few TCM herbs that was used on its own in
Stimulates interferon and interleukins I and II, potent natural immune-boost. formulas, versus the big blends that are common in their formulary.

In the “Superior Medicinals” in the TCM texts=

safe to take daily with no ill effects and helps you live a better life

Reishi “lightens the spirit”

Daoist immortals said it “makes you fly”
Encourages lucid dreaming and spirit travel

Chicken of the woods, Turkey Tails and

Reishi on the clearance of oral human Laetiporus sulphureus (LS) GROUP ONE: 20
patients (LS) clearance was equal to 5%
papillomavirus HPV serotypes 16 and 18
(the two most common HPV strains that
lead to cases of genital cancer).

Among 472 patients who underwent oral swabs for

gingivitis, 61 patients were positive for HPV16 or HPV18.

Polymerase chain reaction (PCR) for HPV was Trametes versicolor (TV), Ganoderma lucidum (GL)
Inhibited proliferation of
performed at inclusion and after 2 months. The
HPV infected cells GROUP TWO: 41 patients (TV+GL) for 2
and induced cell death to use of TV+GL for the clearance of oral HPV deserves
further investigation.
months. clearance was equal to 88% (P<0.001)
cancer cells

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The Reishi (R) suspension was produced as water extract from Altaian mushrooms.
Sprague-Dawley male rats were separated into the following 3 experimental groups:
Group A + R received R (6 days per week) starting 1 week before alcohol
exposure, and during the next 3 weeks, they received both R and alcohol;
group A received alcohol; and group C received water.
At the end of experiment, we determined the metabolic profile using proton magnetic resonance spectroscopy ((1) H
MRS) of the brain cortex and phosphorus magnetic resonance spectroscopy of the liver. Additionally, the blood cells
were collected, and the serum biochemistry and liver histology were performed after euthanasia.

…Moderate alcohol consumption did not cause significant pathological changes in the livers of the experimental
animals. However, 20 days of alcohol consumption significantly increased the number of binuclear hepatocytes
compared to the control. This effect was mitigated in the rats that received the Reishi extract.
Conclusions: Regular administration of the Reishi suspension improved the energy supply to the brain cortex and decreased
the prevalence of inhibitory neurotransmitters that are characteristic of alcohol consumption. The alcohol-induced increase in
liver proliferation was significantly suppressed by regular administration of the G. lucidum water suspension.

Con!ituents we care ab"t

Mushroom Neurologically Bio-Active Compounds

Reishi &
Epilepsy Reishi and Epilepsy
Con!ituents we care ab"t
Mushroom Neurologically Bio-Active Compounds

Epilepsy is a major neurological disorder with frequent seizures due to abnormal neuronal firing and synaptotoxicity and apoptosis of
neurons in the cortico-hippocampal region [67]. Several factors such as apoptotic proteins (Bax/Bad) and cytoplasmic organoids are
associated with apoptosis in the hippocampal neurons [67]. In the mitochondria of epileptiform hippocampal neurons, the damage is
β-glucans, lectins, amino acids, lignin, mycin, and vitamins, which have potential antioxidant, anti- caused by the peroxidation of lipids after the induction of free radicals [67]. It has been experimentally demonstrated that
inflammatory, and neuroprotective effects [62], [63]. Ganodermasides A – D (43 – 46), the Ganodermic acids A and B
biologically active compounds obtained from different parts of G. lucidum, increase life span and play an important role in the regulation of lipid peroxidation and stabilization of the MMP (ψ), thus maintaining the
show anti-aging properties [64], [65], [66]. Other bioactive triterpenoid compounds such as
mitochondrial structure [64]. Similarly, apoptosis is associated with SOD activity and MMP; thus, apoptosis in epileptic
lucidenic acids, 7-oxo-ganoderic acid-Z (47), 4,4,1,4α-trimethyl-5α-chol-7,9 (11)-diene-3-oxo-24-
oic acid (48), ganoderic acid-S1 (49), ganolucidic acid-A (50), methyl ganoderic acid-A (51), and
hippocampus neurons is caused via mitochondrial apoptosis pathways.
methyl ganoderic acid-B (52) from G. lucidum are capable of inducing neurite outgrowth Ganoderic acids A and B significantly improve SOD activity and maintain the MMP in hippocampus neurons, they
protect the hippocampus neurons by inhibiting apoptosis [68], [69]. The ganodermic acid-mediated stabilization of
Fig. 9 Schematic representation of mitochondrial membrane stabilization via action of the antioxidative activity of ganoderic acid (51). The excessive
mitochondrial membranes via its antioxidative activity is represented in [Fig. 9].
accumulation of an excitotoxic insult such as glutamate and its binding on the cell receptor induces ROS generation, which in turn impairs the stabilization of the
mitochondrial membrane and its functions in hippocampal neurons. Mitochondrial damage may also be caused by the results of lipid peroxidation of the membrane.
Ganoderic acid A (51) increased the levels of SOD to inhibit the production of ROS, thereby preserving the integrity of the mitochondrial New identified Lanostane triterpene named Methyl Ganoderate and two known aromatic meroterpenoids, namely,
membranes by improving the MMP of the hippocampal neurons. Due to its mitochondrial membrane stabilizing activity, the release of cytochrome lingzhine E and lingzhine F have been documented to possess neuroprotective activities against H2O2 and aged Aβ-
C from mitochondria may also be greatly reduced by ganoderic acid (51), and thus control the release of apoptotic proteases such as caspases 3 and induced cell death in neuroblastoma SHSY5Y cells, an Alzheimerʼs cell model [70].
9 to protect the hippocampal neurons against epileptic insults.|

https://www.thieme-connect.com/products/ejournals/html/10.1055/a-1177-4834 https://www.thieme-connect.com/products/ejournals/html/10.1055/a-1177-4834

REISHI Research: Brain

Helps prevent damage from and repairs areas of focal blood loss
Phellinus linteus (PL), Ganoderma lucidum (GL), and Inonotus obliquus (IO),
mixed mushroom mycelia (MMM)
Rats were subjected to a 90 min middle cerebral artery
occlusion and reperfusion, after which a wMMM treatment
resulted in significant dose-dependent improvements across a
number of parameters.

Furthermore, measurements of intracellular ROS and levels of antioxidant

enzymes revealed a MMM-mediated ROS attenuation and
antioxidant enzyme up regulation.

We suggest that wMMM is neuroprotective against fCI through its anti-

apoptotic and anti-oxidative effects.

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Grifola frondosa
Maitake, hen of the woods, king of the mushrooms

Anti cancer & Immunomodulation: colon, skin, gastric, osteo, breast

induce hematopoietic cell differentiation
protect those cells from the toxic effects exerted by chemotherapy
Antibacterial
Hypoglycemic, blood sugar regulation, decreases insulin resistance

Anti-oxidant, lipid balancing, Skin benefits

Human dermal fibroblast experiments suggest that a G. frondosa extracellular polysaccharide (GF-EPS) can protect cells from hydroxyl radical-
induced DNA strand breaks, inhibit matrix metalloproteinase expression, stimulate fibroblasts proliferation, and prevent melanin
formation. In addition, GF-MPS can stimulate the biosynthesis of collagen, and was shown to increase the mRNA level of type I collagen in human
dermal fibroblasts

Healthy aging & Fertility tonic

Hepatoprotective
down-regulation of expression of cytochrome P450 and TNF-, cell cycle arrest, decrease of the activities of aspartate
aminotransferase and alanine aminotransferase, and inhibition of superoxide anion oxygen species and RO

Figure 5 Proposed mechanism of GAA-mediated Aβ clearance in vitro.

Different Types of PCOS

Hen of the
woods

Fertility & PCOS

INSULIN RESISTANT
Insulin sensitivy
most common type affecting about 70% of women
diagnosed with PCOS
72 patients with PCOS
High circulating insulin prevents ovulation and triggers the
26 Maitake SX fraction group ==>
ovaries to create testosterone.
76.95% Ovulation
High insulin is not only a symptom, it is also a driver of the
Clomid group ==> 93.5 % ovulation
condition itself.
Causes high androgen levels and menstrual irregularities.
Then those who did not ovulate with
Although PCOS does affect the ovaries and ovulation, it’s
one of the monotherapies- got both
actually a full-body endocrine and metabolic disorder. Insulin
and 13/15 patients then ovulated !!
resistance symptoms include:

Different Types of PCOS PILL INDUCED PCOS is the second most common type of PCOS.
Birth control pills which suppress ovulation. Most women will resume
ovulation and regular periods after discontinuing use. However, some women do
not resume ovulating for months or even years afterward. Diagnosis typically
occurs if your period becomes absent for 3 or more months after discontinuing birth
control pills along with a normal insulin level and signs of PCOS like acne, a high LH
to FSH ratio or possible polycystic ovaries seen on pelvic ultrasound.

INFLAMMATORY PCOS Inflammation prevents ovulation,

hormones become imbalanced and androgens are produced.
Inflammation can be caused by stress, environmental toxins, or food
sensitivities. Chronic inflammation can cause the ovaries to create
excess testosterone and is a contributing factor for every type of
PCOS. The best way to treat inflammatory PCOS is to correct
the underlying source of the inflammation.
IBS or SIBO, joint pain, headaches, or chronic skin conditions such as
psoriasis or eczema.
Inflammatory foods: dairy, sugar, and gluten should be avoided or
minimized.

ADRENAL PCOS
This type of PCOS is due to an abnormal stress response and affects around 10% of
those diagnosed. Typically DHEA-S (another type of androgen from the adrenal glands)
will be elevated alone, and high levels of testosterone and androstenedione are not seen.

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Grifola & Memory

Maitake for Memory & Learning

Methods and results: 20-month-old rats were gavaged with Grifola frondosa
polysaccharides (GFP) for 8 weeks. In the current study, we aimed to explore the beneficial effect of PGM on learning and memory function in aluminum
chloride (AlCl3)-induced amnesia in mice and to explore the underlying mechanisms. Mice were intraperitoneally
administered with AlCl3 (60 mg/kg/d) and PGM (5, 10, or 20 mg/kg/d) for 6 weeks consecutively, and then the Morris
Morris Water Maze test revealed that GFP administration significantly
water maze (MWM) test was conducted to assess the learning and memory function. Hematoxylin-eosin staining was
improved memory impairment in aged rats. performed to observe the morphology of neurons in the hippocampal dentate gyrus (DG). The expression of p-Tau
(Ser396), Tau, p-GluA1 (S845), GluA1, and brain-derived neurotrophic factor (BDNF) proteins was evaluated with
GFP supply was also found to attenuate age-associated changes of brain western blot.

histology and ultrastructure observed by light microscopy and transmission

We found that PGM (5 and 10 mg/kg/d) significantly improved learning and memory function and
electron microscopy. attenuated histopathological abnormalities in the hippocampal DG region in the AlCl3-treated mice.

Moreover, the increase of total antioxidant capacity (T-AOC), glutathione Furthermore, PGM treatment significantly enhanced the level of AMPAR and BDNF in the hippocampus,
while suppressing the tau protein hyperphosphorylation at the Ser396 site. These findings indicated
peroxidase (GPx) activity, superoxide dismutase (SOD) activity, catalase (CAT)
that PGM could significantly attenuate the AlCl3-induced amnesia through the synergistic action of its
activity, as well as the decreased nitric oxide (NO) and malondialdehyde active component on tau pathology, AMPAR and BDNF signaling pathway.
(MDA) levels, were consistent with the behavioral results.

Maitake’s Antidepressant action

1. Think NERVES & BRAIN!

2. Stimulates nerve growth factor
3. Gentle hormone balancing action
4. Antiseptic and anti-inflam,
useful to tx GI ulcers
5. Antioxidant rich
Antidepressant action Proteo-β-glucan from Maitake (PGM) is a strong immune regulator, and its receptor is called Dectin-1.
Cumulative evidence suggests that AMPA receptors are important for the treatment of depression. Here, we
6. As always Beta glucans— immune,
Continual effect all five days (no tolerance developed) report that PGM treatment leads to a significant antidepressant effect in the tail suspension test and
forced swim test after sixty minutes of treatment in mice. After five consecutive days of PGM treatment, cancer, cholesterol etc
this antidepressant effect remained. PGM treatment did not show a hyperactive effect in the
No hyperactive side effects open field test. PGM significantly enhanced the expression of its receptor Dectin-1, as well as p-GluA1(S845) 7. Brain-derived neurotrophic factor
and GluA1, but not GluA2 or GluA3 in the prefrontal cortex (PFC) after five days of treatment. The Dectin-1
Able to ID the Dectin-1 receptor as a main mechanism inhibitor Laminarin was able to block the antidepressant effect of PGM. At the synapses of PFC,
because medications that blocked that action, blunted PGM treatment significantly up-regulated the p-GluA1(S845), GluA1, GluA2, and GluA3 levels. Moreover,
the anti-depressant effect PGM's antidepressant effects and the increase of p-GluA1(S845)/GluA1 lasted for 3 days after
stopping treatment. The AMPA-specific antagonist GYKI 52466 was able to block the antidepressant effect Hardwoods: oak, maple, cherry, birch, aspen,
of PGM. This study identified PGM as a novel antidepressant with clinical potential and a new
Results lasted at least 3 days after treatment stopped
antidepressant mechanism for regulating prefrontal Dectin-1/AMPA receptor signalling.
alder, sycamore. Look up high on dead standing
trees and underneath/ inside fallen ones

Hericium erinaceus LIONS MANE

Hedgehog, monkey head Estrogen receptor alpha
(ERα) activation causes
DEMENTIA, parkinson’s, MS, NEUROPROTECTIVE Trophorestoraive body weight loss and
⍾ Used to treat nerve damage, neuropathy, wound healing uterine weight gain.
⍾ Ability to stimulate the production of nerve growth factor (NGF) **** Longterm activation
Abstract:
⍾ Anxiety, menopause, MRSA increases risk of breast and
Estrogen deficiency during menopause causes a variety of neurological
⍾ Wound healing, skin, corneal and gastric ulcers, esophagus cancer symptoms, including depression. uterine cancers.
⍾ Kills h.pylori, gram positive, gram negative bacteria The edible Lion's Mane mushroom, Hericium erinaceus (Bull.: Fr.) Pers. (HE), is a
⍾ Vast cancer research medicinal mushroom that has the potential for a neuroprotective effect and Hericium does not seem to
ameliorating neurological diseases, such as depression, anxiety, and
act on these very much
⍾ Super antioxidant= tx for diabetic neuropathies neurodegenerative diseases.

⍾ Lipid balancing, hepatoprotective, counteracts ischemia, antiHTN HE contains phytoestrogens, including daidzein and genistein.
However, the ameliorating effect of HE on menopausal symptoms is not well
Hericinones and erinacines- strongly stimulate the synthesis of Nerve Growth aromatic Hericenones : fruiting body understood. Here we investigated the impact of methanol extract of the HE fruiting Estrogen receptor beta (ERβ)
body on depressive-like behavior in postmenopausal model rats.
Factor (NGF). NGF promotes neuron repair and renewal, including myelination. diterpenoid Erinacines : mycelium expressed in the brain, and
Estrogen receptor alpha (ERα) activation causes body weight loss and
activation of ERβ ameliorates
—Plays an essential role in the differentiation and survival of several cell uterine weight gain. [this was not seen with the Hericium]. Body weight
**Critically these molecules are are low gain and uterine weight loss by estrogen deficiency in ovariectomized (OVX) rats menopausal depressive
populations in the central and peripheral nervous system. were reversed with 17β-estradiol (E2) but not with HE. Thus, the phytoestrogens in symptoms.
molecular weight compounds believed to be
—Lower than normal levels of NGF linked to early stages of Alzheimer’s and dementia able to pass through the blood-brain barrier.**
HE may hardly activate ERα .

Estrogen receptor beta (ERβ) is expressed in the brain, and activation of Hericium seemed to activate these
NFG also plays a much wider role in maintaining homoeostasis in the body ERβ ameliorates menopausal depressive symptoms. Notably, depressive-

Cerebrosides: immune reg, anticancer,

phytoestrogens: including like behavior in OVX rats evaluated in forced swim test was reduced by
administration of not only E2 but also HE for 92 d. [this was seen with the
So it may be safer for tx
menopausal symptoms without
(some found in many mushrooms, some unique to lions mane) daidzein and genistein. Hericium].
the same cancer risk
Long-term activation of ERα increases the risk of breast and uterine
Cerebrosides are glycosphingolipids consisting of a ceramide and a single sugar residue at C-1, thus are cancers.
usually named monohexosylceramides or ceramide monohexosides.1 Structurally, ceramide has a long-chain
HE, therefore, may be effective in treating menopausal depression
sphin- gosine or sphingol and an amide-linked long-chain fatty acid, with the sugar moiety being either
without the risk of carcinogenesis caused by ERα activation.
glucose or galactose.

Clinical trials dried fruiting body at a dose of 3-5g/day.

Chinese Phamacopoeia
Gastric ulcers: daily 500mg/kg, which equals up to 25-50g/day

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Lions Mane- Antidepressant & Anti-Anxiety Lions Mane & Cognitive Health

A double-blind, parallel-group, placebo-controlled trial

50- to 80-year-old Japanese men and women diagnosed with mild

cognitive impairment

using a cognitive function scale

30 subjects were randomized into two 15-person groups, one of which

was given Yamabushitake and the other given a placebo.

Yamabushitake group took four 250 mg tablets containing 96% of

Yamabushitake dry powder three times a day for 16 weeks.

After termination of the intake, the subjects were observed for the next
4 weeks.

At weeks 8, 12 and 16 of the trial, the Yamabushitake group

showed significantly increased scores on the cognitive
function scale compared with the placebo group.

The Yamabushitake group's scores increased with the

duration of intake, but at week 4 after the termination of the
30 women going through menopause
16 weeks intake, the scores decreased significantly.
Hericium 0.5g fruiting body powder or placebo cookies for 4 weeks
Improved Symptoms- less depression, insensitivity, anxiety, frustration, Laboratory tests showed no adverse effect of Yamabushitake. The
and palpitations than those taking placebo results obtained in this study suggest that Yamabushitake is effective
in improving mild cognitive impairment.

2,400 × 2,400

Abstract
Osteoarthritis (OA) is an age-related disorder that affects the joints and causes functional
Background: Sleep disruption is a major public health issue and may increase the risk of mortality by ten-folds if an individual is sleeping less than 6 h per night. Sleep has changed
dramatically during to the COVID-19 pandemic because COVID symptoms can lead to psychological distress including anxiety. Hericium erinaceus mycelium has been widely
disability. Hericium erinaceus is a large edible mushroom with several known medicinal
investigated in both the in vivo studies and clinical trials for its neuroprotective functions because the mycelium contains hericenones and erinacines, which synthesize the nerve functions. However, the therapeutic effects of H. erinaceus in OA are unknown.
growth factor and brain-derived neurotrophic factor (BDNF). Recent in vivo reports have shown showed that erinacine A-enriched Hericium erinaceus mycelium can modulate BDNF/
TrkB/PI3K/Akt/GSK-3β pathways to induce an antidepressant-like effect. A large body of evidence indicates that erinacine can pass the blood-brain barrier and suggests its In this study, data from Sprague-Dawley rats with knee OA induced by anterior cruciate
neuroprotective function in both peripheral and central nervous systems. Thus, Hericium erinaceus mycelium may be a dual-function supplement for sleep disruption improvement ligament transection (ACLT) indicated that
while sustaining anxiolytic effects.

Method: To simulate the condition of sleep disruption, the mice were subjected to the tail suspension test (TST) for 15 min every day during the same period for nine consecutive • H. erinaceus mycelium improves ACLT-induced weight-bearing
days. Two different doses (75 and 150 mg/kg) of Hericium erinaceus mycelium were administered orally 20 min prior to the TSTs before entering the light period of 12:12 h L:D cycle. asymmetry and minimizes pain.
All sleep-wake recording was recorded for 24 h using electroencephalogram and electromyogram. The elevated-plus-maze and open-field tests were conducted to record the behavior
activities. • ACLT-induced increases in articular cartilage degradation and
Results: Consecutive TSTs prior to the light period could cause significant sleep disturbance and anxiety behavior in the elevated- bone erosion were significantly reduced by treatment with H.
plus-maze experiments. Results showed that administration with Hericium erinaceus mycelium at 150 mg/kg ameliorated the rodent erinaceus mycelium.
anxiety (p < 0.05) and reversed the TST-induced NREM sleep disturbance in the dark period.
• In addition, H. erinaceus mycelium reduced the synthesis of
Conclusion: This is the first in vivo study suggesting that Hericium erinaceus mycelium has a dual potential role for anxiety relief proinflammatory cytokines interleukin-1β and tumor necrosis
through improving sleep disruptions.
factor-α in OA cartilage and synovium. H. erinaceus mycelium
shows promise as a functional food in the treatment of OA.

Lions Mane- Mood, Sleep & Obesity

8 weeks of oral H. erinaceus supplementation decreased

depression, anxiety, and sleep disorders. H. Memory & learning
erinaceus supplementation improved mood disorders of a
depressive-anxious nature and the quality of the nocturnal How to balance it?
rest. H. erinaceus increased circulating pro-BDNF levels Stress management
without any significant change in BDNF circulating levels. Regular exercise
Clean eating
…and taking psychedelics
brain-derived neurotrophic factor (BDNF) and its precursor pro-BDNF

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 2025 Medicines from the Earth Fungi Medicine - Chimelski

Con!ituents we care ab"t

Hericium coralloides has corallocins a-c that induce nerve growth Mushroom Neurologically Bio-Active Compounds
and brain derived neurotrophic factor just like lions mane!

Hericium erinaceus
Fig. 10 Schematic description of
Erinacine A mediated antioxidative and
anti-inflammatory activity in the
intermittent ischemic brain injury.
An ischemic injury or stroke produces oxidative stress (ROS) that
leads to the generation of nitric oxide, a mediator of protein
nitrosylation, that leads to the phosphorylation of p38 MAPK and
CHOP and the phosphorylated p38 MAPK/CHOP involved in the ER
stress signaling pathway-mediated neuronal death. The oxidative
damage of the brain also upregulates proinflammatory cytokines.
Erinacine A treatment reduced the levels of iNOS/
RNS, phosphorylated p38 MAPK, CHOP,
nitrotyrosine protein, and proinflammatory
cytokines such as IL-1β, IL-6, and TNF-α in a stroke
animal model.

https://www.thieme-connect.com/products/ejournals/html/10.1055/a-1177-4834

Con!ituents we care ab"t

Mushroom Neurologically Bio-Active Compounds

Hericium erinaceus
Fig. 11 The involvement of the PI3K/Akt and Erk1/2 signaling pathways in

Hericeone E induced neuronal outgrowth. The

neuroprotective activity of hericenone E may mimic the
action of the endogenous synthesized nerve growth factor
that induced neuronal outgrowth by binding with the TrkA
receptor, thereby either activating the ERK or PI3K/AKT
signaling pathway.
The involvement of PI3K/AKT or ERK in hericeone E (64)-
induced neurite outgrowth was elucidated by use of a
specific ERK (U0126 or PD98059) or PI3K class I inhibitor
(LY294002), respectively, which abrogated the hericeone E
(64)-induced neurite growth or neuritogenesis.|

https://www.thieme-connect.com/products/ejournals/html/10.1055/a-1177-4834

Lions Mane- Antidepressant Action

Lions Mane-Neuron Inflammation moderator

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 2025 Medicines from the Earth Fungi Medicine - Chimelski

Lions Mane- Antidepressant Action Lions Mane- Antidepressant Action

Lions mane also targets:

Neurotrophic/Neurogenic Hypothesis and
Inflammatory Hypothesis

Lions Mane- Mood, Sleep & Obesity

Obtained data revealed the normal growth of the nerve and glial cells with extract at
cultivating.
No pathologic or toxic action of the extract has been found.
The cell ultrastructure was intact and similar to that observed in vivo.
The process of myelination in the presence of the extract began earlier as compared to
controls and was characterised by a higher rate.
Thus, extract of H. erinaceus promoted normal development of cultivated cerebellar cells
and demonstrated a regulatory effect on the process of myelin genesis process in vitro.

Chaga Inonotus obliquus

Super Antioxidant
CHAGA Chaga has the highest ORAC score ever recorded in
any natural food! 6.5 times more than Acai berry.

Anti-inflammatory
Anti-viral & Anti-parasitic
Neuroprotective /Antineurodegenerative
Adaptogen, Endurance, Anti-fatigue
sclerotium
Immunomodulation
Anti-Cancer- many mechanisms
Blood Sugar, Metabolic Regulation & Anti-diabetic
mechanisms
Active Constituents
Triterpenoids
Inotodiol
Trametonolic acid
Betulinic acid
Vitamin B2, vitamin D, calcium, iron, magnesium,
phosphorus, manganese
Melanin
Sesquiterpenes Grows predominantly on birch trees, but may
also be found on ash, elm, beech, alder

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 2025 Medicines from the Earth Fungi Medicine - Chimelski

CHAGA
Chaga and Oxalates:
Important Health Considerations
Oxalate Content and Kidney Health
Chaga does contain oxalates, so you need to be mindful with
existing kidney issues or stones. It should not be taken in
excessive amounts for ongoing periods of time without
monitoring the kidneys.

Relative Oxalate Content

Chaga typically has a lower oxalate content than spinach but
proportionally it is still good to be cautious if there are kidney
issues, because the dose can be higher. Some people take very
high doses of for prolonged periods of time (more than they
would ingest spinach or other leafy greens).

Types of Oxalates and Their Effects

Insoluble oxalates (calcium ,magnesium, iron oxalates) that

are not absorbed and harmlessly pass through the colon.
Soluble oxalates (potassium and sodium oxalate) release
free anions which pass into the bloodstream. These may
bind to free calcium and produce calcium oxalate crystals
that could lead to kidney stones, gout, or kidney damage. It
also depletes calcium from where it is needed elsewhere.

CHAGA CHAGA

Chaga, Memory & Learning

Mouse study
Mice given amnesia with scopolamine then treated with chaga extract
Multiple Sclerosis & Phellinus igniarius
Showed improvements in memory and learning
Decreased oxidative stress, increased SOD and glutathione
Inhibits excess Acetylcholine esterase (the enzyme that
breaks it down) to increase/balance acetylcholine levels.

• Acetylcholine is used all throughout the

brain and body, huge impact on
functionality and mental health
• Paying attention, memory, learning,
spatial awareness, arousal. “meshima” translates to “women’s island”
• Acetylcholine binds to receptors on the in Japanese as it supports women’s health
muscle fiber to cause contraction. black hoof mushroom, Conk Mushroom
• Depletion is associated with Alzheimer’s,
• specifically loss of AchE enzyme

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3922003/
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 2025 Medicines from the Earth Fungi Medicine - Chimelski

Multiple Sclerosis & Phellinus igniarius Multiple Sclerosis & Phellinus igniarius

Sham
Clear, visible
differences in
Control autoimmune
Just MOG myelin cell
oligodendrocyte infiltration/
glycoprotein
staining/
inflammation
MOG and Piwep —
water-ethanol extract Much less in
of Phellinus igniarius those with
Phellinus
Piwep treatment attenuates EAE-induced immune cell infiltration into white matter of
spinal cord in mice. PFA fixed sections of the thoracic spinal cord were
immunohistochemically stained with antibodies against cell surface molecules such as CD4,
CD8, F4/80, and CD20. Immunostaining revealed that T cell, B cell, and microglia/
macrophage labeled cells extensively infiltrated the white matter of EAE mice (MOG +
vehicle). However, Piwep treatment reduced the infiltration of immune cells into the white
matter of the spinal cords in EAE mice (MOG + Piwep). Scale bar represents 100 μm.

Piwep treatment attenuates EAE-induced mononuclear cell infiltration into the white matter of spinal cord, cerebral cortex, and cerebellum in mice. Three

Turkey Tails & Alzheimer’s

Cholinesterase inhibition (like Donepezil)

High in antioxidants, free radical scavenging activity
Flavonoids like baicalin and quercetin

Turkey Tails & Alzheimer’s

Cholinesterase inhibition of different phenolic compounds from turkey tails
Baicalein as the most potent inhibitor; combined with the quercertin likely most AchE activity
Apigenin, baicalein, kaempferol and quercetin expressed inhibitory effect above 90% at 100 μM.
Daidzein also inhibited the respective enzyme, at the lower extent.
p-hydroxybenzoic acid was found is and is also known to exhibit the Cholinesterase inhibition
Also terpenoids, flavonoids and other phenolic substances
also show inhibition of AChE activity.

Polyphenolic and polysaccharide compounds are linked to

each other

The water soluble triterpenoid compounds in the H2O

turkey tail extract may also contribute both to the
antioxidant activity and synergistic effect of these
compounds with polysaccharides, phenols and flavonoids
as suggested by others

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Psilocybe TR Depression Clinical studies& Research on Psilocybin and

Psilocybin Anxiety
“magic mushrooms” OCD
Alzheimers
⍾ Psilocybin and psilocin, indolealkylamines, are structurally similar to the Parkinsons
neurotransmitter serotonin (5-hydroxytryptamine or 5-HT). Two other tryptamines — baeocystin and Auto Immune
norbaeocystin — could be present but are thought to be less active.
Eating Disorders
Psilocybe cubensis- over 200 known strains
⍾ Psilocin mainly interacts with 5-HT1A, 5-HT2A and 5-HT2C receptor subtypes: a mixed Migraines & Cluster HA
Psiolcybe semilanceata- liberty caps
Psilocybe azurescens- flying saucer
Psilocybe tampanesis- Magic truffles, philosopher’s stone
receptor agonist. Smoking Addiction
Psilocybe cyanescens- Wavy Caps
Copelandia cyanescens/ Panaeolus cyanescens-
⍾ Unlike MDMA, Psilocybe do not just flood the brain with serotonin. They target a Alcohol Addiction
Menstrual Cycle Issues
Blue meanies (different from p.cubensis blue meanies strain)
Psilocybe caerulescens- Landslide mushrooms
specific subtype of serotonin receptor—the 5-HT2A receptor—to which they bind directly,
thereby activating it. Body Dysmorphic Disorder
⍾ The 5-HT2A receptor is known to play a key role in regulating mood, anxiety,
Suicide Ideations
schizophrenia and consciousness Marginalized Populations
⍾ Many trials- micro and macro dosing PTSD, OCD, Migraines, PD, Anxiety, Suicide etc. Sexual Functioning
Fibromyalgia
⍾ Hallucinogenic mushroom use found in the Sahara Desert and date back to 7000 to 9000 years ago.
⍾ Traditionally used by Mayans, aztec and many other native tribes throughout Mexico and California

MushWomb Medicine Lindsay Chimileski ND LAc RH(AHG)

Behavior and emotional responses, regulating your SSRIs target the 5-ht1a receptor
hunger, thirst, response to pain, levels of pleasure, Changes our tolerance to stress by
sexual satisfaction, anger and aggressive behavior Encouraging patiences and emotional resistance
SSRIs target the 5-ht1a receptor but it can BLUNTING
They help us TOLERATE stress.
Cope with things that are hard; grin and bear it
Anti stress/ pro coping
Psychedelics target the 5-ht2a receptor
Adapt and change
Outside of just the limbic system
Related to neuroplasticity
Environmental sensitivity
Learning and UNLEARNING
Adaption and change
Enhance sensitivity
Facilitate emotional release
Pro-therapeutic
Psychedelics target the 5-ht2a receptor
a measure of the brain's overall
—Not just grinning and bearing it; actually making space to adapt ourselves
flexibility or readiness to or environments to impact change
encounter unpredictable stimuli —May be 1-3 or less frequent doses can have such lasting impact
and they found that it correlated
5-HT2A receptors are in the high level association regions of the brain
influencing cognition, perception.
with intelligence
—Lowest activity in the PMC or brain areas more connected to motor function

SINGLE DOSE psilocybin vs. single

dose niacin

Follow ups showed improvements

4.5 years after!

Anxiety, Depression, Hopelessness,

Demoralization,
Death Anxiety

Mushroom Medicine Dr. Lindsay Chimileski, ND LAc.

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 2025 Medicines from the Earth Fungi Medicine - Chimelski

Abstract

Background: A recent open-label pilot study (N = 15) found that two to three moderate to high
doses (20 and 30 mg/70 kg) of the serotonin 2A receptor agonist, psilocybin, in combination
Addiction and alcohol misuse disorders with cognitive behavioral therapy (CBT) for smoking cessation, resulted in
343 respondents, mostly White (89%), males (78%), in the USA (60%) substantially higher 6-month smoking abstinence rates than are typically
completed the survey. observed with other medications or CBT alone.
Participants reported seven years of problematic alcohol use on average before Objectives: To assess long-term effects of a psilocybin-facilitated smoking cessation program at
the psychedelic experience to which they attributed reduced alcohol ≥12 months after psilocybin administration.
consumption, with 72% meeting retrospective criteria for severe AUD. Methods: The present report describes biologically verified smoking abstinence outcomes of the
Most reported taking a moderate or high dose of LSD (38%) or psilocybin (36%), previous pilot study at ≥12 months, and related data on subjective effects of psilocybin.
followed by significant reduction in alcohol consumption.
Results: All 15 participants completed a 12-month follow-up, and 12 (80%) returned for a
After the psychedelic experience 83% no longer met AUD criteria. long-term (≥16 months) follow-up, with a mean interval of 30 months (range = 16-57 months)
Participants rated their psychedelic experience as highly meaningful between target-quit date (i.e., first psilocybin session) and long-term follow-up. At 12-month follow-
and insightful, with 28% endorsing psychedelic-associated changes up, 10 participants (67%) were confirmed as smoking abstinent. At long-term follow-up, nine They sell Nicotine gum and patch as
in life priorities or values as facilitating reduced alcohol misuse. participants (60%) were confirmed as smoking abstinent. At 12-month follow-up 13 “statistically significant” at 6-15%! and you
participants (86.7%) rated their psilocybin experiences among the five most
Greater psychedelic dose, insight, mystical-type effects, and personal meaning have to keep using them as replacement
personally meaningful and spiritually significant experiences of their lives.
of experiences were associated with a greater reduction in alcohol
Conclusion: These results suggest that in the context of a structured treatment program, 2-3 high dose Psilocybin sessions
consumption, controlling for prior alcohol consumption and related distress
psilocybin holds considerable promise in promoting long-term smoking abstinence. The present
study adds to recent and historical evidence suggesting high success rates when using classic
+ CBT therapy =
psychedelics in the treatment of addiction. Further research investigating psilocybin-facilitated 60% smoking abstinent
treatment of substance use disorders is warranted.

helping to heal a broken society at long term follow up

Fungi Wisdom Apprenticeship. Lindsay Chimileski ND LAc RH(AHG)

Abstract
Background: Recent evidence suggests that psychedelic use predicts reduced perpetration of intimate partner violence among men
involved in the criminal justice system. However, the extent to which this association generalizes to community samples has not been
examined, and potential mechanisms underlying this association have not been directly explored. Amanita muscaria toadstools demonstrating the range of colours and
fruiting body shapes observed for this species. The scales seen on the
Aims: The present study examined the association between lifetime psychedelic use and intimate partner violence among a community caps of this species are remnants of the universal veil that surrounds
sample of men and women. The study also tested the extent to which the associations were mediated by improved emotion regulation. the immature fruiting body (Copyright © Alan Rockefeller).

Methods: We surveyed 1266 community members aged 16-70 (mean age=22.78, standard
deviation =7.71) using an online questionnaire that queried substance use, emotional regulation, and
TOOLS FOR BETTER
intimate partner violence. Respondents were coded as psychedelic users if they reported one or more
instance of using lysergic acid diethylamide and/or psilocybin mushrooms in their lifetime. Results/ EMOTIONAL
outcomes: Males reporting any experience using lysergic acid diethylamide and/or REGULATION
B. Toxic compounds produced by Amanita fungi.
psilocybin mushrooms had decreased odds of perpetrating physical violence To help all genders
against their current partner (odds ratio=0.42, p<0.05). Huge potential for pain control, anxiety, depression etc depending on the constitution of the
Better regulated society?! individual / circumstances.
Furthermore, our analyses revealed that male psychedelic users reported better
emotion regulation when compared to males with no history of psychedelic use. Less violence and crime
Ibotenic acid acts as an agonist of the glutamate at the
Better emotion regulation mediated the relationship between psychedelic use and for all
lower perpetration of intimate partner violence. This relationship did not extend to females N-methyl-d-aspartate (NMDA) glutamate receptors
within our sample. Living in harmony with the while muscimol is a gamma-aminobutyric acid (GABA) agonist,
natural ways of ourselves/
Conclusions/interpretation: These findings extend prior research showing a negative relationship the natural world within
targeting GABAA receptor.

Fly Agaric
between psychedelic use and intimate partner violence, and highlight the potential role of emotion and without us. Amanita species is responsible for amatoxin and the very deadly death cap mushroom,
regulation in this association.
great caution needed distinguishing between the edible and very deadly species

Amanita
Botanical Medicine : Dr. muscaria
Lindsay Chimileski ©

Ibotenic acid= glutamate agonist at the while Muscimol=GABA agonist,

N-methyl-d-aspartate (NMDA) glutamate receptors targeting GABAA receptor
(gamma-aminobutyric acid )

The excitatory effects characterized by

Following is a phase of tiredness and deep sleep, in which
elation, giddiness, hyperactivity, muscle
it may be difficult to arouse the patient. During this phase,
tremors, and distortion of space and time
vivid hallucinations and manic excitement may oscillate
begin approximately 30 minutes to 2 hours
with periods of deep sleep. The duration of effect is up to
after ingestion and are likely to be mediated
12 hours. Prolonged sleep withA. muscaria ingestion
by ibotenic acid.
requires only observation and supportive care. Tonic-clonic
seizures are reported, but occurrences are rare.

OYSTERS & Culinary Fungi: immunocompromised

Mushroom Medicine for Everyone. Lindsay Chimileski ND LAc RH(AHG)

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Choosing Potent
Medicinal Mushroom Dosing
is going to vary greatly depending on your Mushroom Medicines
goals and the extraction forms you are using.
FRUITING BODIES
More active beta glucans
Price, digestion are the main limiting factors,
What has always been traditionally used
very safe. Minimal digestive upset usually
Mycelium can be 50-80% grains
only adverse reaction.
EXTRACTED POWDER > Raw
Whole mushroom powder doses or dried Raw powders use hot water extraction at least -
Chinese Pharmacopoeia Doses
range from 2 to 16 to 50 grams in divided make tea, soup etc due to chitin
Maitake 2 to 25 grams of whole powder daily.
doses. At least 6g in most for therapeutic
Oysters: 3-9 grams daily
DOUBLE EXTRACTION “best” in simple terms
dose. to get both alcohol and water soluble constituents
Chaga: Powder is 1-3grams daily BETA GLUCANS- hot water soluble
Can be prescribed as a tea, soup or food (fresh or dried) too! TRITERPENOIDS- alcohol
Resihi 6 to 12 grams daily
Tinctures, Standardized extracts can be dosed lower but more Cook your mushrooms!
Lion’s Mane: 25-50grams daily
often than not, the goal is still to get to high doses when
really using mushrooms as a targeted therapy. Still will be
250-750mg used in trials for cognitive function. 3-5g used in clinical trials, 5g fruiting body
in soup. 500mg/kg. DOSE- Whole mushroom/powder doses range from
beneficial at lower doses though, just more for vitality, 2 to 16 to 50 grams in divided daily doses. At least 6g
wellness, prevention side. Phellinus linteus: 30grams daily dried, if polysaccharide extract 2-3g/
day is common. in most for therapeutic Chinese Pharmacopoeia Doses

Shiitake: 6–16 grams; fresh-about 90 grams

Doses from Christopher Hobbs Medicinal Mushrooms III, drugs.com medication database and the Chinese pharmacopoeia

Foraging Safety Foundations

1. The “Banana” Rule : You should be as confident at ID the item you are going
to eat as you are at IDing a banana
2. It is a good practice to learn the ID in stages. ID it in the field a few times,
bring samples to check with books or peers. After confidently IDing it 2-3x
then think about eating it.
3. Eat one new wild item at a time. Especially if you tend to have a reactive
system or digestive issues. You want to be able to know which items cause
symptoms if you had any.
4. Eat small amounts of the item the first time. That way if you have a reaction it
is not as severe. Especially true for mushrooms, for example chicken of the
woods.
All of our medicinal mushrooms are going to touch on these 5. Always check and learn the deadly or poison look a-a-likes so you know how
to correctly tell between the two and confidently select the safe option.
mechanisms—due to shared basic polysaccharides,
antioxidants, minerals, triterpenoids and vitamins. 6. If there are any doubts, don’t.
Of course there are some nuances to it and specific indications but in general they ALL will help brain health.

Environmental Steward Thank you !

harvesting rules
1. Know your local endangered species and do not collect, if in doubt, don’t collect.
2. Know your local invasive, and do collect.
3. Harvest upper plant parts, stems, leaves, flowers things that regrow each season
more than roots, bulbs tree bark or parts that would prevent it from growing
again.
4. Rule of 3: harvest only if you see *at least* 3 of that kind in the area you are
harvesting from.
5. Rule of “thirds”- never harvest more than a 3rd of what you see.
6. Take only what you need. Don’t get overzealous, harvest what you will use, try
not to waste.
7. Mindful exchange and gratitude- this can be done many ways based on your
preference but some kind of thank you and appreciation while harvesting.
8. Bring an extra bag for collecting trash you see along the way as a thank you to
the system.
9. Return to spread seed other times of the years.
10. Use sharp tools when you can for clean cuts and less stress on the plant
11. Be respectful of local indigenous practices that utilize these wild allies and do
not deplete their sources simply bc it is trendy or you are selling something.
12. Be mindful, smart and safe- be aware of where you are harvesting for run off/
pesticides, environmental hazards, ticks, poison ivy. Minimize reckless driving
when you spot a mushroom on the side of the road.

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Brain Fungi & Nootropic

Mushrooms
no·o·trop·ic
/ˌnōəˈträpik/
1. (of a drug) used to enhance memory or other cognitive functions.
2. Nootropics (/noʊ.əˈtroʊpɪks/ noh-ə-TROHP-iks, or /noʊ.əˈtrɒpɪks/ noh-ə-
TROP-iks[1]) (colloquial: smart drugs and cognitive enhancers)
are drugs, supplements, and other substances that are claimed to
improve cognitive function, particularly executive functions, attention,
memory, creativity, or motivation, in healthy individuals.
Wikipedia

Potent mushroom medicines for brain health, focus, happiness & longevity
Dr. Lindsay Chimileski
Mushroom Medicine `` Lindsay Chimileski ND Lac RH Mushroom Medicine with Lindsay Chimileski ND LAc RH

Mushroomy Mechanisms for Brain Health —Building blocks of essential nutrients for neurons
-High in antioxidants and minerals & neurotransmitters

-Immune regulation: beta-glucans, Serotonin, Betacarotenes, Vitamin D2

Antibody Antibody opsonization —Healthy & youthful skin

Anti-viral & Stealth pathogen targeting —Yin building and moisturizing to the system

(often a part of the pathology) —Stimulating, ADHD

Auto-immune degeneration like MS —Seizure Formulas

-Cholesterol balance & Cardiovascular health —Mitochondrial support

-Blood flow, prevention & treatment of Ischemic events —Brain longevity, cognitive function, memory,
learning
-Blood Sugar balance/Insulin/Metabolic Balance
—Hormones balancing
-Neuronal tissue affinity & can cross and stabilize the blood
brain barrier —Adaptogenic, Stress balance

-Cancer surveillance and adjunctive/direct and recovery of —Supports physical recovery, endurance and
stamina
All of our medicinal mushrooms are going to touch on these chemo/radiation treatments
—Quality of life & Mental health, Nervines
mechanisms—due to shared basic polysaccharides, -Gut health/healing, balanced flora, prebiotic, biofilm bust
-Liver health Tastes delicious
antioxidants, minerals, triterpenoids and vitamins. Fun to hunt in the woods! and make weird
-Detox& Metal chelating: liver, kidneys, lungs skin
Of course there are some nuances to it and specific indications but in general they mushroom friends & community
-Buffering toxic burden, i.e. cigarette smoke, pollution
ALL will help brain health. —Entheogenic & Psychedelic
—AWE!
Mushroom Medicine with Lindsay Chimileski ND LAc RH

Nutritional Powerhouse

Mushroom Medicine as food.

This is why everyone is so jazzed up
about medicinal mushrooms

Mushroom Medicine with Lindsay Chimileski ND LAc RH Lindsay Chimileski ND LAc RH(AHG)

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Cook Your Mushrooms!

Heat, water, salt, fat etc all help to break down
the chitin, to exposes active molecules

ALWAYS cook your mushrooms for better

absorption of active constituents and
Generalized Benefits of Medicinal Mushrooms nutrients.
mostly via the b-glucans and antioxidants which are present in all Tastes better too! Uncooked more likely to have issues
with contamination and some causes dermatitis, i.e.
• Heart disease- balancing lipids, inflammation and oxidation
• Immune system balance But if the health and taste benefits of cooked aren’t enough for you…
• Acute or chronic, prevention, palliative or targeted immune and cancer therapies Shiitake flagellate Dermatitis
• Liver support- detoxification support, tissue healing, antiviral (hepatitis), can help the burden of • Rare skin eruption
• Resembles whiplash marks
many medications on the liver • Occurs after consumption of raw
• Digestive health & healing inflamed digestive tissues shiitake
• Reaction to lentinan, a thermolabil
• Skin health- yin/moisture building, antioxidant, detoxication/liver/digestion polysaccharide which decomposes
• Many have anti-diabetic, anti-obesity and blood sugar balancing actions too upon heating
• Linearly arranged erythematous,
pruritic papules on trunk, limbs
• Usually self-limited, resolving within
10 days of onset.
Lindsay Chimileski ND LAc RH(AHG) Lindsay Chimileski ND LAc RH(AHG)

= 5-10 grams of Mushroom Medicine Details

shiitakes daily Variables that influence the outcomes
to improve • What part of the mushroom is it?
immune health
• What life stage?
• Fruiting Body or Mycelium?
•
52 healthy adults
5 or 10 g of mushrooms daily for If mycelium, what kind…
4 weeks.
= improved immune cell counts
Reduced CRP, inflammation
North spore graphic

Fresh Mushrooms
~ 90% water
Versus some 500 mg raw 141 g
cap of myceliated oats
28 g
Mushroom medicine Lindsay Chimileski ND Lac RH Lindsay Chimileski ND LAc RH(AHG)

Choosing Potent
Mushroom Medicines
the need to knows
Fruiting Body: Mycelium:
What has always classically been used: the ethnobotany, TCM
Typically grown on grain, oats, corn etc
FRUITING BODIES
and traditional use/ foundation we build on. More active beta glucans
Less investment, faster & easier grow in masses, faster turnover.
Most research research is on the fruiting bodies; more now on
Typically less active compounds- up to 50% less beta-glucans than What has always been traditionally used
mycelium
fruiting bodies 50-80% starch from the growing substrate— Mycelium can be 50-80% grains
Active, “full spectrum” More active constituents- beta-glucans,
I think of it as a fermented food such as tempeh- still has nutritional value
antioxidants, triterpenes, minerals (phosphorus, copper, zinc,
potassium); vitamins (C, D, beta-carotene, Bs). * one known
but not as much of the strong medicinal actions EXTRACTED POWDER > Raw
Pure mycelium extracts grown in liquid fermentation tanks to get
exception is erinacine A in lions mane mycelium [hericenones C &D in Raw powders use hot water extraction at least -
mycelium without growth substrate
fruiting body]
Potential for different beneficial components, enzymes higher etc, make tea, soup etc due to chitin
we just do not know all those constituents yet. More and more research
is being done. Likely a great medicines too, but different. Use combos if anything.
DOUBLE EXTRACTION “best” in simple terms
to get both alcohol and water soluble constituents
BETA GLUCANS- hot water soluble
TRITERPENOIDS- alcohol

DOSE- Whole mushroom/powder doses range from

2 to 16 to 50 grams in divided daily doses. At least 6g
in most for therapeutic Chinese Pharmacopoeia Doses

Lindsay Chimileski ND LAc RH(AHG) Lindsay Chimileski ND LAc RH(AHG)

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Con!ituents we care ab"t

Beta-glucans

Triple helix polysaccharides (beta-D glucans)

• Natural sources such as mushrooms, yeast, algae, cereal grains and bacteria.
• All fungi and yeasts have triple helix polysaccharides (beta-D glucans) in their cell walls, contributing to structural support
• Glucose polymer-chain core or repeating d-glucose polymers bonded at carbon 1 of the saccharide ring to the carbon 3 or 6 of the
next (beta 1-3, beta 1-6)
• Not all beta-glucans are equally effective at triggering an appropriate immune response: Depends on the core chain length, complexity of
branching, molecular structure, degrees of branching and solubility, differences in molecular weight and solution conformation, and methods of
production, extraction and purification. It is suggested the more complex, the more active immunomodulatory and anti-cancer effects.
• Most medicinal mushrooms have β-1,3;1,6-glucans (bacteria often 1,4)
—> Heat breaks down chitin, exposes active molecules = cook your mushrooms to get the medicine!
—> Large molecular weight fungal compounds bind to gut receptors to initiate complex immune activation via dectin, toll-like
receptors and others. Evidence suggests that the activity of these polysaccharides is dependent on their size, with high molecular
weight (100 000–200 000) fractions being most active, while fractions from the same source with molecular weights of 500–10 000
show no activity. The fact that there are polysaccharides with different chemical structures, but all of which have immunomodulating activity, suggests
that the immune response is in part non-specific, determined by size rather than by chemical structure.

Lindsay Chimileski ND LAc RH(AHG)

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Con!ituents we care ab"t

Psilocybin
• Psilocybin and psilocin, indolealkylamines, are structurally similar
• To the neurotransmitter serotonin (5-hydroxytryptamine or 5-HT).
• Psilocin mainly interacts with 5-HT1A, 5-HT2A and 5-HT2C receptor
subtypes: a mixed receptor agonist.
• Unlike MDMA, Psilocybe do not just flood the brain with
serotonin. They target a specific subtype of serotonin receptor—the
5-HT2A receptor—to which they bind directly, thereby activating it/
• The 5-HT2A receptor is known to play a key role in regulating
mood, anxiety, schizophrenia, trauma processing, PTSD, joy,
creativity and consciousness

Lindsay Chimileski ND LAc RH(AHG)

Con!ituents we care ab"t

Mushroom Neurologically Bio-Active Compounds

MANY fungi show the ability to

induce neurite growth: Mushrooms for
Sarcodon spp/ pheasant back
Cyanthus spp./Birdnest fungi Depression, Mood,
Anxiety, Sleep Quality
Fig. 3 Proposed model on the underlying mechanism of action of Happiness, Motivation, Awe, Enjoyment,
cyrneine A (1) and scabromine G methyl ester (14) and induced neurite outgrowth.
Treatment of cyrneine A (1)-induced neuronal differentiation through the formation of lamellipodia and filopodia at the growth cones Learning, Connection versus isolation—
as a result of actin polymerization via the Rac1-dependent pathway. Cynereine A (1) treatment may have enhanced the level of PI3K, which in
turn activated the guanosine exchange factor, which not only converted the inactive Rac (Ras-related C protein)-GDP to Rac-GTP but also activated
the Rac1 protein and cell division control protein 42, which are key molecules in promoting lamellipodia and filopodia, respectively. SG-ME (14) All very important for brain health and dementia prevention,
probably binds to TrkA and potently activated the IKK/NF-κB complex to release the NFκB from IKK via PKC-ζ activation. NFκB can
then be translocated into the nucleus where it binds with a transcription factor (AP-1) to initiate further transcriptional expression of
Lucky for us- mushrooms can help with that on many levels too!
neurotrophic factors that promoted neurite outgrowth. NFκB is a key transcription factor involved in processes of synaptic
plasticity and memory.|

Mushroom Medicine with Lindsay Chimileski ND LAc RH Mushroom Medicine with Lindsay Chimileski ND LAc RH

Immune balancing actions of mushrooms

Decades of research on it (in addition to centuries of traditional use).
Immune actions have downstream impacts on brain health.
Just about all edible/medicinal mushrooms are going to have these
impacts via beta-glucans, phenolic compounds and antioxidants
Mushroom Immune Balance action on brain health
• Helps prevent autoimmune degeneration like MS
• Many different antiviral mechanisms
• Helps to fight infections that can trigger formation of amyloid plaques
in the brain, connected to Alzheimers disease. New research shows
these plaques often form to encapsulate an infective agent i.e. stealth
teeth strep infections etc
• Stealth pathogens will also steal resources, energy and focus from
younger, “healthy” individuals i.e. college students with recurrent
mono or Lyme, covid long haulers, candid, dysbiosis
• Surveying for cancers

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IMPORTANCE OF PREVENTION
NATUROPATHIC DOCS
+ MUSHROOMS EXCELL AT THIS

=antioxidants
=build the blood
=enhance lymph/ emunctories
=immunomodulation
=stabilize blood brain barrier Triterpenes

=provide nutrients needed & Triterpenoids

=enhance detoxification
=enhance enzyme function
=enhance cellular function
(mitochondria, controlled cell death, lipid bilayer, signaling)

Hot gossip- White button, Cremini, Portobello are all the same species
Auricularia (auricula-judae, polytricha, spp.)
Wood Ear, Jelly Ear, Mu-err Caution: blood thinning “szechwan purpura”

Agaricus bisporus
Cloud ear, jelly fungus, anticoagulant effect. In 1980, a U.S. case of “Szechwan Purpura” was reported in the New
England Journal of Medicine. A 32-year-old U.S. researcher (during an experiment using his own
Black Fungus, Tree jelly fish blood platelets for clotting) found after some 50 trials one morning that his platelets would not
agglutinate or release serotonin on exposure to epinephrine. It continued to inhibit platelet
response in the researcher and other volunteers for 3-24 days. Like aspirin (or other platelet
inhibitors) this mushroom should not be ingested prior to surgery or in patients with

White: fresh, young; common, inexpensive, champignon poor blood clotting.

Cremini/ Baby Bella: brown strain of button mushroom &

Traditional Chinese Medicine ⍾ Used in TCM cooking as early as 300-200BC.
immature Portobello, chestnut brown
⍾ Flavor & Energetics: sweet, neutral; lung, stomach, liver, spleen, kidney, large intestine meridians.
Portobello: fully mature, thick, meaty texture; Campellone ⍾ Actions: nourishes yin and moisturizes, replenishes qi, revives blood, gently cools to stop bleeding, moistens and
mushroom, roman mushroom clears lung qi, build blood, build stomach qi, nourishing and moistening.
⍾ Indications: Dry cough, Urine with blood, metrorrhagia, hemorrhoids, blood deficiency.

⍾ Heart disease & circulation balancing, Anti-coagulant, Balances cholesterol

⍾ Hypoglycemic, Hepatoprotective, Antiviral, Anti-tumor
⍾ Healthy Aging, Skin Beauty tonic
⍾ Anti-inflammatory for skin, mucus and eyes
⍾ Vitamins: B1, B2, B5 (40% RDA in 100g raw mushroom), B6, B9. Minerals: Copper, Iron, Magnesium,
Selenium, Zinc, Fiber, protein, calcium, phosphorus.
⍾ Asian culinary staple- adds consistency/texture/crunch more than flavor.
⍾ Contains lecithin for lipid cell membrane health and oxidation. Linoleic acids, soluble fiber, antioxidants.

Saprophytic, deciduous wood-decaying (Maple, Oak,

Ash, European Elder). Found all year round.
Clusters gelatinous sporocarp fruiting body,
rubbery, flexible, fine surface hairs; edible

Mushroom medicine Lindsay Chimileski ND Lac RH Mushroom Medicine for Everyone. Lindsay Chimileski ND LAc RH(AHG)

Auricularia polytricha Potential use in Alzheimer's and amyloid

plaque formation, helps stimulate the enzymes
that cleave or breaks down the plaques Cordyceps sinensis
Caterpillar fungus Adaptogen, Energy
Himalayan Viagra Promoting, Anti-tumor,
Anti-inflammatory,
Antioxidant,
Hepatoprotective

Classic Adapotogen: Improves energy, stamina, physical

performance and quality of life
Traditional Chinese Uses: Cough, chronic bronchitis,
respiratory dysfunctions, kidney disorders, frequent nocturia,
male sexual dysfunction, liver disease, dizziness, weakness,
waisting and opium addiction Lung, Immune, Adrenal affinity

Immunostimulating polysaccharide galactomannins, cordycepic acid.

Amino Acids, Fatty Acids, Polyamines, Ecdysterones, Adenosine, B-
Vitamins, polysaccharides, ophiocordin (an antibiotic compound),
cordycepin, cordypyridones, nucleosides, bioxanthracenes, sterols,
alkenoic acids, and exo-polymers.

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Forms of Cordyceps
Cordyceps sinensis Almost all of the supplements are not true cordyceps sinensis bc of its extremely high price-
wild cordyceps costs up to $20,000 per kilogram; rarely even sold in North America.
Cordyceps militaris
⍾ Cordyceps Cs-4. Cordyceps sinensis is difficult to grow in the lab or on different substrates, still
not really affordably cultivated to this day. In the 1980s, scientists made Cordyceps anamorphs, mycelium
growth that are unable to produce a mushroom fruiting body.

Using liquid fermentation, these anamorphs were grown to create mass amounts of pure mycelium (this method uses a
liquid culture mycelium or liquid fermentation nutrients which are then removed, leaving the pure mycelium). These
anamorphs were studied extensively and found to produce similar results to the wild Cordyceps sinensis —
> now known as Cordyceps Cs-4. Many clinical trials in China, the Chinese government approved its use in
TCM hospitals and is recognized as a safe natural product drug. If a Cordyceps supplement is claiming to
be Cordyceps sinensis and it is made in China, it is almost always Cordyceps Cs-4.

Cordyceps
myceliated
grain

Cordyceps sinensis CS4 liquid grow tanks

Cordyceps militaris.
Cordyceps species that can be commercially cultivated at scale to produce a
mushroom (fruiting body); becoming quite popular. Tests on par with sinensis.
Made from the mushroom fruit body= higher levels of the important beta-glucans.
Mushroom Medicine Lindsay Chimileski ND Lac RH Medicinal Mushrooms and Oncology. Lindsay Chimileski ND LAc RH(AHG)

Cordyceps & Ischemic Brain Injury

WIB801C, the standardized extract of Cordyceps militaris
used to treat rats that had had induced ischemic injuries (no blood flow to certain areas of the
brain

WIB801C significantly decreased migration of cultured microglia/macrophages.

This anti-chemotactic activity of WIB-801C was not mediated via adenosine A3 receptors, although
cordycepin, the major ingredient of WIB801C, is known as an adenosine receptor agonist.

Post-ischemic treatment with WIB801C significantly reduced the infiltration of ED-1-and MPO-
positive inflammatory cells into ischemic lesions in tMCAO rats.

20 adults, double blind placebo controlled WIB801C-treated rats exhibited significantly decreased infarct volume and cerebral
edema, less white matter and blood-brain barrier damages, and improved
333mg TID or placebo for 12 weeks.
neurological deficits.
Improved exercise performance & wellness
WIB801C also improved survival rates over 34 days after ischemia onset.

A significant reduction in infarct volume and neurobehavioral deficits by WIB801C

was also observed in rats subjected to pMCAO.

Conclusions: In summary, post-ischemic treatment of WIB801C reduced infiltration of

inflammatory cells into ischemic lesions via inhibition of chemotaxis, which confers long-lasting
histological and neurological protection in ischemic brain. WIB801C may be a promising anti-
ischemic drug candidate with clinically relevant therapeutic time window and safety.

Mushroom medicine Lindsay Chimileski ND Lac RH Mushroom Medicine Lindsay Chimileski ND Lac RH

RESULTS:
Ganoderma lucidum REISHI, Ling Zhi
Mushroom of spiritual potency
Cellular senescence was unregulated by CSE
(cigarette smoke treatment adaptogen, immune stimulant, antioxidant
C. sinensis can decrease CSE-induced cellular
senescence.
⍾TCM: Tonifies Jing, Qi and Shen. calmness, centeredness,
balance, inner awareness and inner strength.
Activation of ROS/PI3K/AKT/mTOR ⍾Asia as a tonic herb consumed for the attainment of
signaling pathway was enhanced by radiant health, longevity and spiritual attainment.
CSE treatment, and decreased when C.
sinensis was added. ⍾ In the middle ages- used by mountain hermits, monks, Taoist
adepts and spiritual seekers throughout Asia to help calm the mind,
ease tension, strengthen the nerves, strengthen memory, sharpen
Blocking ROS/PI3K/AKT/mTOR signaling concentration, improve focus, build will power and, as a result, help
pathway can attenuate CSE-induced cellular build wisdom.
senescence.
Called the "Mushroom of Spiritual Potency" by these seekers.

Conclusion ⍾ Used to improve meditative practices and to protect the body,

CSE can induce cellular senescence in human mind and spirit so that the adept could attain both a long and
bronchial epithelial cells, and ROS/PI3K/AKT/mTOR healthy life.
signaling pathway may play an important role in
this process. C. sinensis can inhibit the CSE-
induced senescence.
Nootropic Medicinal Mushrooms. Lindsay Chimileski ND LAc RH(AHG) Mushroom medicine Lindsay Chimileski ND Lac RH

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The Auspicious Fungus

Finding it was a blessing
Great luck/ very special / a gift
The spirits of the mountain favoring you

Rituals & astrology to help find it

Sage naturalist would go into the mountains carrying specific talismans,
a white chicken or a white dog to gain favor of the mountain spirits

Reishi was such a sacred finding, that the mountain spirits would guard it.
If you did not pay honor to them, they would not show you the reishi-
You could walk right by it and not see it.
Reishi “lightens the spirit”
Only ones who could afford it were the emperors and wealthy
Daoist immortals said it “makes you fly”
Because it was so special, it is one of the few TCM herbs that was used on its own in
formulas, versus the big blends that are common in their formulary. Encourages lucid dreaming and spirit travel

In the “Superior Medicinals” in the TCM texts= safe to take daily with no ill effects and
helps you live a better life
Fungi Wisdom Mushroom Apprenticeship Lindsay Chimileski ND LAc RH(AHG) MushWomb Medicine Lindsay Chimileski ND LAc RH(AHG)

REISHI Research: Brain REISHI Research: Brain

REISHI Research: Liver and Brain REISHI Research: Brain

The present study was designed to systematically evaluate the anti-
amnesic effect of selected Ganoderma species i.e. G. mediosinense
and G. ramosissimum.

Extracts of selected mushroom species were evaluated for their

antioxidant activity and acetylcholinesterase (AChE) inhibition
using in-vitro assays (DPPH and Ellman tests respectively).

The anti-amnesic potential of the most active extract (i.e. 70%

methanol extract of G. mediosinense) was confirmed using
mouse model of scopolamine-induced amnesia.
The Reishi (R) suspension was produced as water extract from Altaian mushrooms.
Sprague-Dawley male rats were separated into the following 3 experimental groups: Mice were treated with bioactive extract and donepezil once orally
before the induction of amnesia.
Group A + R received R (6 days per week) starting 1 week before alcohol
exposure, and during the next 3 weeks, they received both R and alcohol; Cognitive functions were evaluated using passive shock avoidance
(PSA) and novel object recognition (NOR) tests.
group A received alcohol; and group C received water.
At the end of experiment, we determined the metabolic profile using proton magnetic The effect on brain AChE activity, brain oxidative stress (TBARS
resonance spectroscopy ((1) H MRS) of the brain cortex and phosphorus magnetic level) and neuronal damage (H & E staining) were also assessed.

resonance spectroscopy of the liver. Additionally, the blood cells were collected, and the In-vitro results showed strong antioxidant and AChE inhibitory
serum biochemistry and liver histology were performed after euthanasia. activities by G. mediosinense extract (GME). Therefore, it was
selected for in-vivo studies.

…Moderate alcohol consumption did not cause significant pathological changes in the livers of the experimental AChE inhibitor= Prevention potential GME pre-treatment (800mg/kg, p.o.) reversed the effect of

animals. However, 20 days of alcohol consumption significantly increased the number of binuclear hepatocytes Alzheimer’s Parkinson’s dementia scopolamine in mice, evident by significant decrease (p <0.05) in
the transfer latency time and increase in object recognition index in
Cholinesterase inhibitors (also called acetylcholinesterase
compared to the control. This effect was mitigated in the rats that received the Reishi extract. inhibitors) are a group of medicines that block the normal
PSA and NOR, respectively.
GME significantly reduced the brain AChE activity and
breakdown of acetylcholine- keeping it circulating for
longer. Acetylcholine is the main neurotransmitter found in the oxidative stress.
Conclusions: Regular administration of the Reishi suspension improved the energy supply to the brain cortex and decreased body and has functions in both the peripheral nervous system Histopathological examination of brain tissues showed
the prevalence of inhibitory neurotransmitters that are characteristic of alcohol consumption. The alcohol-induced increase in and the central nervous system. decrease in vacuolated cytoplasm and increase in pyramidal
cells in brain hippocampal and cortical regions.
liver proliferation was significantly suppressed by regular administration of the G. lucidum water suspension. GME exerts anti-amnesic effect through AChE inhibition and
antioxidant mechanisms.
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REISHI Research: Brain REISHI Research: Brain

Mushroom Medicine with Lindsay Chimileski ND LAc RH Mushroom Medicine with Lindsay Chimileski ND LAc RH

REISHI Research: Brain Con!ituents we care ab"t

Mushroom Neurologically Bio-Active Compounds

Reishi &
Epilepsy

β-glucans, lectins, amino acids, lignin, mycin, and vitamins, which have potential antioxidant, anti-
inflammatory, and neuroprotective effects [62], [63]. Ganodermasides A – D (43 – 46), the
biologically active compounds obtained from different parts of G. lucidum, increase life span and
show anti-aging properties [64], [65], [66]. Other bioactive triterpenoid compounds such as
lucidenic acids, 7-oxo-ganoderic acid-Z (47), 4,4,1,4α-trimethyl-5α-chol-7,9 (11)-diene-3-oxo-24-
oic acid (48), ganoderic acid-S1 (49), ganolucidic acid-A (50), methyl ganoderic acid-A (51), and
methyl ganoderic acid-B (52) from G. lucidum are capable of inducing neurite outgrowth
Fig. 9 Schematic representation of mitochondrial membrane stabilization via action of the antioxidative activity of ganoderic acid (51). The excessive
mycelium of the Lingzhi or Reishi medicinal mushroom Ganoderma lucidum inhibited accumulation of an excitotoxic insult such as glutamate and its binding on the cell receptor induces ROS generation, which in turn impairs the stabilization of the
convulsions in rats from KA-induced seizures, reduced the degeneration pattern in mitochondrial membrane and its functions in hippocampal neurons. Mitochondrial damage may also be caused by the results of lipid peroxidation of the membrane.
Ganoderic acid A (51) increased the levels of SOD to inhibit the production of ROS, thereby preserving the integrity of the mitochondrial
the CA3 region of rats, decreased astrocytic reactivity, and reduced the expression of
membranes by improving the MMP of the hippocampal neurons. Due to its mitochondrial membrane stabilizing activity, the release of cytochrome
IL-1β and TNF-α induced by KA. These results indicate a potential anticonvulsant and C from mitochondria may also be greatly reduced by ganoderic acid (51), and thus control the release of apoptotic proteases such as caspases 3 and
neuroprotective effects of GLOS. 9 to protect the hippocampal neurons against epileptic insults.|

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Con!ituents we care ab"t Con!ituents we care ab"t

Reishi and Epilepsy Mushroom Neurologically Bio-Active Compounds Reishi and Epilepsy Mushroom Neurologically Bio-Active Compounds

Epilepsy is a major neurological disorder with frequent seizures due to abnormal neuronal firing and synaptotoxicity and apoptosis of
Two new Benzendiols, designated as lucidumins B and C, along with two new alkaloids,
neurons in the cortico-hippocampal region [67]. Several factors such as apoptotic proteins (Bax/Bad) and cytoplasmic organoids are namely, lucidimine E and ganocochlearine A, have shown remarkable neuroprotective
associated with apoptosis in the hippocampal neurons [67]. In the mitochondria of epileptiform hippocampal neurons, the damage is activity against corticosteroid-induced cytotoxicity in PC12 cells [71].
caused by the peroxidation of lipids after the induction of free radicals [67]. It has been experimentally demonstrated that
Ganodermic acids A and B
In patients with depressive disorders, glucocorticoids such as corticosterone and cortisol are secreted at a
play an important role in the regulation of lipid peroxidation and stabilization of the MMP (ψ), thus maintaining the
mitochondrial structure [64]. Similarly, apoptosis is associated with SOD activity and MMP; thus, apoptosis in epileptic
high level due to the dysfunction and hyperactivity of the hypothalamic-pituitary-adrenal axis, which
hippocampus neurons is caused via mitochondrial apoptosis pathways. further leads to damage to hippocampal neurons, followed by depressive symptoms [72], [73], [74].
Ganoderic acids A and B significantly improve SOD activity and maintain the MMP in hippocampus neurons, they Hence, the neuroprotective effect of lucidumins and lucidimines against glucocorticoids-
protect the hippocampus neurons by inhibiting apoptosis [68], [69]. The ganodermic acid-mediated stabilization of induced hippocampus dysfunction may play a protective role in fighting depression. The
mitochondrial membranes via its antioxidative activity is represented in [Fig. 9].
above studies indicate that G. lucidum may have potential for the treatment of neurodegenerative
New identified Lanostane triterpene named Methyl Ganoderate and two known aromatic meroterpenoids, namely,
diseases and other neurological disorders.
lingzhine E and lingzhine F have been documented to possess neuroprotective activities against H2O2 and aged Aβ-
induced cell death in neuroblastoma SHSY5Y cells, an Alzheimerʼs cell model [70]. =Adaptogenic action for mood and brain health, longevity.

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Figure 5 Proposed mechanism of GAA-mediated Aβ clearance in vitro.

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REISHI Research: Brain

Grifola frondosa
Maitake, hen of the woods, king of the mushrooms

Anti cancer & Immunomodulation: colon, skin, gastric, osteo, breast

induce hematopoietic cell differentiation
Helps prevent damage from and repairs areas of focal blood loss protect those cells from the toxic effects exerted by chemotherapy
Phellinus linteus (PL), Ganoderma lucidum (GL), and Inonotus obliquus (IO), Antibacterial
mixed mushroom mycelia (MMM) Hypoglycemic, blood sugar regulation, decreases insulin resistance
Rats were subjected to a 90 min middle cerebral artery enhancing insulin sensitivity and ameliorating insulin resistance of peripheral target tissues
occlusion and reperfusion, after which a wMMM treatment Polysaccharides can enhance glucose uptake by HepG2 cells, activate the insulin receptor protein in the cell membrane,
resulted in significant dose-dependent improvements across a and increase phosphorylated AktSer473 production, thereby relieving insulin resistance.
number of parameters. Anti-oxidant, lipid balancing, Skin benefits
Human dermal fibroblast experiments suggest that a G. frondosa extracellular polysaccharide (GF-EPS) can protect cells from hydroxyl radical-
induced DNA strand breaks, inhibit matrix metalloproteinase expression, stimulate fibroblasts proliferation, and prevent melanin
Furthermore, measurements of intracellular ROS and levels of antioxidant formation. In addition, GF-MPS can stimulate the biosynthesis of collagen, and was shown to increase the mRNA level of type I collagen in
enzymes revealed a MMM-mediated ROS attenuation and human dermal fibroblasts
antioxidant enzyme up regulation. Healthy aging & Fertility tonic
Hepatoprotective
We suggest that wMMM is neuroprotective against fCI through its anti- down-regulation of expression of cytochrome P450 and TNF-, cell cycle arrest, decrease of the activities of aspartate
apoptotic and anti-oxidative effects.
Botanical Medicine : Dr. Lin
aminotransferase and alanine aminotransferase, and inhibition of superoxide anion oxygen species and RO

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Grifola & Memory

Methods and results: 20-month-old rats were gavaged with Grifola frondosa
polysaccharides (GFP) for 8 weeks.

Morris Water Maze test revealed that GFP administration significantly

improved memory impairment in aged rats.

GFP supply was also found to attenuate age-associated changes of brain

histology and ultrastructure observed by light microscopy and transmission
electron microscopy.

Moreover, the increase of total antioxidant capacity (T-AOC), glutathione

peroxidase (GPx) activity, superoxide dismutase (SOD) activity, catalase (CAT)
activity, as well as the decreased nitric oxide (NO) and malondialdehyde
(MDA) levels, were consistent with the behavioral results.

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Maitake’s Antidepressant action

Maitake for Memory & Learning

In the current study, we aimed to explore the beneficial effect of PGM on learning and memory function in aluminum
chloride (AlCl3)-induced amnesia in mice and to explore the underlying mechanisms. Mice were intraperitoneally
administered with AlCl3 (60 mg/kg/d) and PGM (5, 10, or 20 mg/kg/d) for 6 weeks consecutively, and then the Morris
water maze (MWM) test was conducted to assess the learning and memory function. Hematoxylin-eosin staining was
performed to observe the morphology of neurons in the hippocampal dentate gyrus (DG). The expression of p-Tau
(Ser396), Tau, p-GluA1 (S845), GluA1, and brain-derived neurotrophic factor (BDNF) proteins was evaluated with Antidepressant action Proteo-β-glucan from Maitake (PGM) is a strong immune regulator, and its receptor is called Dectin-1.
western blot. Cumulative evidence suggests that AMPA receptors are important for the treatment of depression. Here, we
Continual effect all five days (no tolerance report that PGM treatment leads to a significant antidepressant effect in the tail suspension test and
We found that PGM (5 and 10 mg/kg/d) significantly improved learning and memory function and developed) forced swim test after sixty minutes of treatment in mice. After five consecutive days of PGM treatment,
attenuated histopathological abnormalities in the hippocampal DG region in the AlCl3-treated mice. this antidepressant effect remained. PGM treatment did not show a hyperactive effect in the
open field test. PGM significantly enhanced the expression of its receptor Dectin-1, as well as p-GluA1(S845)
No hyperactive side effects
Furthermore, PGM treatment significantly enhanced the level of AMPAR and BDNF in the hippocampus, and GluA1, but not GluA2 or GluA3 in the prefrontal cortex (PFC) after five days of treatment. The Dectin-1
while suppressing the tau protein hyperphosphorylation at the Ser396 site. These findings indicated inhibitor Laminarin was able to block the antidepressant effect of PGM. At the synapses of PFC,
Able to ID the Dectin-1 receptor as a main PGM treatment significantly up-regulated the p-GluA1(S845), GluA1, GluA2, and GluA3 levels. Moreover,
that PGM could significantly attenuate the AlCl3-induced amnesia through the synergistic action of its
mechanism because medications that blocked PGM's antidepressant effects and the increase of p-GluA1(S845)/GluA1 lasted for 3 days after
active component on tau pathology, AMPAR and BDNF signaling pathway. stopping treatment. The AMPA-specific antagonist GYKI 52466 was able to block the antidepressant effect
that action, blunted the anti-depressant effect
of PGM. This study identified PGM as a novel antidepressant with clinical potential and a new
antidepressant mechanism for regulating prefrontal Dectin-1/AMPA receptor signalling.
Results lasted at least 3 days after treatment
stopped

Lindsay Chimileski ND LAc RH(AHG)

Hericium erinaceus LIONS MANE

Hedgehog, monkey head Estrogen receptor alpha
(ERα) activation causes
DEMENTIA, parkinson’s, MS, NEUROPROTECTIVE Trophorestoraive body weight loss and
⍾ Used to treat nerve damage, neuropathy, wound healing uterine weight gain.
⍾ Ability to stimulate the production of nerve growth factor (NGF) **** Longterm activation
Abstract:
⍾ Anxiety, menopause, MRSA increases risk of breast and
Estrogen deficiency during menopause causes a variety of neurological
⍾ Wound healing, skin, corneal and gastric ulcers, esophagus cancer symptoms, including depression. uterine cancers.
⍾ Kills h.pylori, gram positive, gram negative bacteria The edible Lion's Mane mushroom, Hericium erinaceus (Bull.: Fr.) Pers. (HE), is a
⍾ Vast cancer research medicinal mushroom that has the potential for a neuroprotective effect and Hericium does not seem to
ameliorating neurological diseases, such as depression, anxiety, and
act on these very much
⍾ Super antioxidant= tx for diabetic neuropathies neurodegenerative diseases.

⍾ Lipid balancing, hepatoprotective, counteracts ischemia, antiHTN HE contains phytoestrogens, including daidzein and genistein.
However, the ameliorating effect of HE on menopausal symptoms is not well
Hericinones and erinacines- strongly stimulate the synthesis of Nerve Growth aromatic Hericenones : fruiting body understood. Here we investigated the impact of methanol extract of the HE fruiting Estrogen receptor beta (ERβ)
body on depressive-like behavior in postmenopausal model rats.
Factor (NGF). NGF promotes neuron repair and renewal, including myelination. diterpenoid Erinacines : mycelium expressed in the brain, and
Estrogen receptor alpha (ERα) activation causes body weight loss and
activation of ERβ ameliorates
—Plays an essential role in the differentiation and survival of several cell uterine weight gain. [this was not seen with the Hericium]. Body weight
**Critically these molecules are are low gain and uterine weight loss by estrogen deficiency in ovariectomized (OVX) rats menopausal depressive
populations in the central and peripheral nervous system. were reversed with 17β-estradiol (E2) but not with HE. Thus, the phytoestrogens in symptoms.
molecular weight compounds believed to be
—Lower than normal levels of NGF linked to early stages of Alzheimer’s and dementia able to pass through the blood-brain barrier.**
HE may hardly activate ERα .

Estrogen receptor beta (ERβ) is expressed in the brain, and activation of Hericium seemed to activate these
NFG also plays a much wider role in maintaining homoeostasis in the body ERβ ameliorates menopausal depressive symptoms. Notably, depressive-

Cerebrosides: immune reg, anticancer,

phytoestrogens: including like behavior in OVX rats evaluated in forced swim test was reduced by
administration of not only E2 but also HE for 92 d. [this was seen with the
So it may be safer for tx
menopausal symptoms without
(some found in many mushrooms, some unique to lions mane) daidzein and genistein. Hericium].
the same cancer risk
Long-term activation of ERα increases the risk of breast and uterine
Cerebrosides are glycosphingolipids consisting of a ceramide and a single sugar residue at C-1, thus are cancers.
usually named monohexosylceramides or ceramide monohexosides.1 Structurally, ceramide has a long-chain
HE, therefore, may be effective in treating menopausal depression
sphin- gosine or sphingol and an amide-linked long-chain fatty acid, with the sugar moiety being either
without the risk of carcinogenesis caused by ERα activation.
glucose or galactose.

Clinical trials dried fruiting body at a dose of 3-5g/day.

Chinese Phamacopoeia
Gastric ulcers: daily 500mg/kg, which equals up to 25-50g/day

Con!ituents we care ab"t

Hericium coralloides has corallocins a-c that induce nerve growth Mushroom Neurologically Bio-Active Compounds
and brain derived neurotrophic factor just like lions mane!

Hericium erinaceus
Fig. 10 Schematic description of
Erinacine A mediated antioxidative and
anti-inflammatory activity in the
intermittent ischemic brain injury.
An ischemic injury or stroke produces oxidative stress (ROS) that
leads to the generation of nitric oxide, a mediator of protein
nitrosylation, that leads to the phosphorylation of p38 MAPK and
CHOP and the phosphorylated p38 MAPK/CHOP involved in the ER
stress signaling pathway-mediated neuronal death. The oxidative
damage of the brain also upregulates proinflammatory cytokines.
Erinacine A treatment reduced the levels of iNOS/
RNS, phosphorylated p38 MAPK, CHOP,
nitrotyrosine protein, and proinflammatory
cytokines such as IL-1β, IL-6, and TNF-α in a stroke
animal model.

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Con!ituents we care ab"t

Mushroom Neurologically Bio-Active Compounds

Hericium erinaceus
Fig. 11 The involvement of the PI3K/Akt and Erk1/2 signaling pathways in

Hericeone E induced neuronal outgrowth. The

neuroprotective activity of hericenone E may mimic the
action of the endogenous synthesized nerve growth factor
that induced neuronal outgrowth by binding with the TrkA
receptor, thereby either activating the ERK or PI3K/AKT
signaling pathway.
The involvement of PI3K/AKT or ERK in hericeone E (64)-
induced neurite outgrowth was elucidated by use of a
specific ERK (U0126 or PD98059) or PI3K class I inhibitor
(LY294002), respectively, which abrogated the hericeone E
(64)-induced neurite growth or neuritogenesis.|

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Lions Mane- Antidepressant & Anti-Anxiety Lions Mane-Neuron Inflammation moderator

30 women going through menopause

Hericium 0.5g fruiting body powder or placebo cookies for 4 weeks
Improved Symptoms- less depression, insensitivity, anxiety, frustration,
and palpitations than those taking placebo

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Lions Mane- Antidepressant Action Lions Mane- Antidepressant Action

Lions mane also targets:

Neurotrophic/Neurogenic Hypothesis and
Inflammatory Hypothesis

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Lions Mane- Antidepressant Action Lions Mane- Mood, Sleep & Obesity

8 weeks of oral H. erinaceus supplementation decreased depression, anxiety,

and sleep disorders. H. erinaceus supplementation improved mood
disorders of a depressive-anxious nature and the quality of the nocturnal
rest. H. erinaceus increased circulating pro-BDNF levels without any
significant change in BDNF circulating levels.

brain-derived neurotrophic factor (BDNF) and its precursor pro-BDNF

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Lions Mane- Mood, Sleep & Obesity Lions Mane- Mood, Sleep & Obesity

See this image and copyright information in PMC

Figure 3 (a) Mean score values ± SEM obtained by means of SCL-90 in H. erinaceus group before (T0), after
(T1), and in H. erinaceus wash-out condition (T2) in (DEP), anxiety (ANX), and sleep disorders (SLEEP). (b)
Patients selected for symptomatology before (T0), after (T1), and in H. erinaceus wash-out condition (T2).
The ∗p<0.05 and ∗∗p<0.01 obtained by the comparison versus T0 (according one-way ANOVA, Tukey post hoc
test). The comparison of values between T1 and T2 does not show any statistically significant differences.
Mean values ± SEM of Zung’s depression (DEP), Zung’s anxiety (ANX), and binge eating scale (BES) tested by self-evaluation: (a) control and (b) H.
erinaceus groups before (T0), after (T1), and in H. erinaceus. (c) Patients in control condition selected for symptomatology in T0, T1, and T2. (d) Patients
selected for symptomatology before (T0), after (T1), and in H. erinaceus wash-out condition (T2). p<0.05 and p<0.01 were obtained by the comparison
versus T0 in any experimental group (according to two-way ANOVA). The comparison of values between T1 and T2 does not show any statistically
significant differences.

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Lions Mane- Mood, Sleep & Obesity Lions Mane- Mood, Sleep & Obesity

Figure 5 (a) Pro-BDNF, BDNF, and (b) pro-BDNF/BDNF ratio serum levels ± SEM in
patients treated with H. erinaceus at T0, T1, and T2. ∗p<0.05 indicates significant
differences between different time versus T0 tested by paired Student's t-test. The
comparison of values between T1 and T2 does not show any statistically significant
differences.

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Lions Mane & Cognitive Health

A double-blind, parallel-group, placebo-controlled trial

50- to 80-year-old Japanese men and women diagnosed with mild

cognitive impairment

using a cognitive function scale

30 subjects were randomized into two 15-person groups, one of which

was given Yamabushitake and the other given a placebo.

Yamabushitake group took four 250 mg tablets containing 96% of

Yamabushitake dry powder three times a day for 16 weeks.

After termination of the intake, the subjects were observed for the next
4 weeks.
Obtained data revealed the normal growth of the nerve and glial cells with extract at
At weeks 8, 12 and 16 of the trial, the Yamabushitake group cultivating.
showed significantly increased scores on the cognitive
function scale compared with the placebo group.
No pathologic or toxic action of the extract has been found.
The cell ultrastructure was intact and similar to that observed in vivo.
The Yamabushitake group's scores increased with the
duration of intake, but at week 4 after the termination of the
The process of myelination in the presence of the extract began earlier as compared to
16 weeks intake, the scores decreased significantly. controls and was characterised by a higher rate.
Laboratory tests showed no adverse effect of Yamabushitake. The Thus, extract of H. erinaceus promoted normal development of cultivated cerebellar cells
results obtained in this study suggest that Yamabushitake is effective and demonstrated a regulatory effect on the process of myelin genesis process in vitro.
in improving mild cognitive impairment.

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Inonotus obliquus Triterpenoids

Chaga
vitamin B2, vitamin D,
Antioxidant, Inotodiol calcium, iron, magnesium,
Antineurodegenerative phosphorus, manganese
Trametonolic acid
Adaptogen, Endurance
Immunomodulation Betulinic acid
Cancer research Melanin
Blood sugar regulation
sclerotium

MANY cancer modulating actions- antitumor, anti-mutagenic, antiviral, immunomodulating, allergy lowering
In vitro, animal studies mostly, some human trials- colon cancers hepatomas, selective apoptosis in tumor
cells with no effects on healthy cells reduced toxicity associated with radiation, and inhibited melanoma cell
growth in animal models
Anti-diabetic and blood sugar balancing actions
Immune system focused adaptogen— for those who catch viruses when run down, ie. Cold sores etc
Analgesic, Anti-inflammatory and pain-relieving properties
Reduced oxidative stress in lymphocytes from patients with inflammatory bowel disease.
Cognition-enhancing and antioxidant activities
Increased exercise endurance and biological measures related to fatigue
CAUTIONS: May interact with anticoagulant and anti-diabetic drugs. High in oxalates and excessive intake may
have toxic effects because of this- kidney stones, bladder sensitivity and spasms.

Grows predominantly on birch trees, but may

Medicinal Mushrooms Lindsay Chimileski ND LAc RH(AHG) also be found on ash, elm, beech, alder

CHAGA
Chaga, Memory & Learning
Chaga has the highest ORAC score ever recorded in
any natural food! 6.5 times more than Acai berry. Mouse study
Mice given amnesia with scopolamine then treated with chaga extract
Showed improvements in memory and learning
Decreased oxidative stress, increased SOD and glutathione
Inhibits excess Acetylcholine esterase (the enzyme that
breaks it down) to increase/balance acetylcholine levels.

• Acetylcholine is used all throughout the

brain and body, huge impact on
functionality and mental health
• Paying attention, memory, learning,
spatial awareness, arousal.
• Acetylcholine binds to receptors on the
muscle fiber to cause contraction.
• Depletion is associated with Alzheimer’s,
• specifically loss of AchE enzyme

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Yellow Morel Morels &

Morchella esculenta Alzheimer’s &
Parkinson’s Prevention
Bioactive ingredients:
Polysaccharides
Polyphenolic compounds
Proteins, and protein hydrolysates
Triterpenoids

Morchella esculenta polysaccharides (MEP) possess multiple

bioactivities such as antioxidant, anti-inflammation,
immunoregulation, hypoglycemic activity, Antioxidants
atherosclerosis prevention and antitumor ability.
Polysaccharopeptides
The substances extracted from both natural collected and Beta glucans
submerged fermented M. esculenta are promising for AChE inhibitor
antioxidants, immunomodulation, anti-cancer and anti- —> Alzheimer’s Parkinson’s dementia
inflammatory applications.
Prevention potential

Fungi Wisdom Apprenticeship Lindsay Chimileski ND LAc RH

Mushroom Medicine with Lindsay Chimileski ND LAc RH

Multiple Sclerosis & Phellinus igniarius

Multiple Sclerosis & Phellinus igniarius

Sham
Clear, visible
differences in
Control autoimmune
Just MOG myelin cell
oligodendrocyte infiltration/
glycoprotein
staining/
inflammation
MOG and Piwep —
water-ethanol extract Much less in
“meshima” translates to “women’s island” of Phellinus igniarius those with
in Japanese as it supports women’s health
Phellinus
black hoof mushroom, Conk Mushroom
Piwep treatment attenuates EAE-induced immune cell infiltration into white matter of
spinal cord in mice. PFA fixed sections of the thoracic spinal cord were
immunohistochemically stained with antibodies against cell surface molecules such as CD4,
CD8, F4/80, and CD20. Immunostaining revealed that T cell, B cell, and microglia/
macrophage labeled cells extensively infiltrated the white matter of EAE mice (MOG +
vehicle). However, Piwep treatment reduced the infiltration of immune cells into the white
matter of the spinal cords in EAE mice (MOG + Piwep). Scale bar represents 100 μm.

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3922003/

Multiple Sclerosis & Phellinus igniarius

Poria cocos & Alzheimer’s

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Piwep treatment attenuates EAE-induced mononuclear cell infiltration into the white matter of spinal cord, cerebral cortex, and cerebellum in mice. Three

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Poria Anti-Amnesia

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Turkey Tails & Alzheimer’s

Cholinesterase inhibition (like Donepezil)

High in antioxidants, free radical scavenging activity
Flavonoids like baicalin and quercetin

Mushroom Medicine for Everyone. Lindsay Chimileski ND LAc RH(AHG)

Turkey Tails & Alzheimer’s

Cholinesterase inhibition of different phenolic compounds from turkey tails Turkey Tails & Alzheimer’s
Baicalein as the most potent inhibitor; combined with the quercertin likely most AchE activity
Apigenin, baicalein, kaempferol and quercetin expressed inhibitory effect above 90% at 100 μM.
Daidzein also inhibited the respective enzyme, at the lower extent.
p-hydroxybenzoic acid was found is and is also known to exhibit the Cholinesterase inhibition

Also terpenoids, flavonoids and other phenolic substances

also show inhibition of AChE activity.

Polyphenolic and polysaccharide compounds are linked to

each other

The water soluble triterpenoid compounds in the H2O

turkey tail extract may also contribute both to the
antioxidant activity and synergistic effect of these
compounds with polysaccharides, phenols and flavonoids
as suggested by others

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Mushrooms for Mushrooms for

Neuronal Health Neuronal Health
& as Antioxidant & as Antioxidant

Plate 1 Selected culinary and medicinal medicinal mushrooms with neurite outgrowth stimulatory
activity. a: H. erinaceus; b: P. giganteus; c: G. lucidium; d: L. rhinocerotis; d: G.neo-japonicum

Mushroom Medicine with Lindsay Chimileski ND LAc RH

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3924982/

Mushrooms for
Neuronal Health
Mushrooms for
& as Antioxidant Neuronal Health
& as Antioxidant

Figure 1 The effects of an aqueous extract of fruiting bodies of H. erinaceus grown in a tropical climate. a: Negative control (without treatment);
b: NGF (20 ng/ml); c: Aqueous extract of H. erinaceus (extensive neurite outgrowth)

Figure 2 The morphology of PC-12Adh cells. Arrows indicate neurite extensions. a: Negative control - F-12K medium only; b: Positive control -
50 ng/mL (w/v) of NGF; c: 50 μg/mL of G. neo-japonicum

Figure 4 Effects of NGF and P. giganteus extracts on

Figure 3 Neurofilament staining to confirm neurite outgrowth neurite outgrowth using PC12 as an in vitro model.
* P < 0.05 compared to NGF (the positive control)[29]

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Amanita muscaria toadstools demonstrating the range of colours and

fruiting body shapes observed for this species. The scales seen on the
caps of this species are remnants of the universal veil that surrounds
the immature fruiting body (Copyright © Alan Rockefeller).

Psychedelics & Entheogens

Connected, Community, Tapping into the Collective Consciousness B. Toxic compounds produced by Amanita fungi.
Individualized Trauma healing/ Mushroom Guides Huge potential for pain control, anxiety, depression etc depending on the constitution of the
individual / circumstances.
Neuroplasticity and new neural networks and connections
Ibotenic acid acts as an agonist of the glutamate at the
Training brain adaptability and learning/ unlearning N-methyl-d-aspartate (NMDA) glutamate receptors
Balancing default mode network while muscimol is a gamma-aminobutyric acid (GABA) agonist,
Potential to retrain awe response and childlike wonder when paired with nature targeting GABAA receptor.

Fly Agaric
Amanita species is responsible for amatoxin and the very deadly death cap mushroom,
great caution needed distinguishing between the edible and very deadly species

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Botanical Medicine : Dr. muscaria
Lindsay Chimileski ©
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Ibotenic acid= glutamate agonist at the

N-methyl-d-aspartate (NMDA) glutamate receptors
while Muscimol=GABA agonist,
targeting GABAA receptor
Psilocybe
(gamma-aminobutyric acid ) Psilocybin
“magic mushrooms”

⍾ Psilocybin and psilocin, indolealkylamines, are structurally similar to the

neurotransmitter serotonin (5-hydroxytryptamine or 5-HT). Two other tryptamines — baeocystin and
norbaeocystin — could be present but are thought to be less active.

⍾ Psilocin mainly interacts with 5-HT1A, 5-HT2A and 5-HT2C receptor subtypes: a mixed
Psilocybe cubensis- over 200 known strains
Psiolcybe semilanceata- liberty caps receptor agonist.
Psilocybe azurescens- flying saucer
Psilocybe tampanesis- Magic truffles, philosopher’s stone
Psilocybe cyanescens- Wavy Caps
Copelandia cyanescens/ Panaeolus cyanescens-
Blue meanies (different from p.cubensis blue meanies strain)
⍾ Unlike MDMA, Psilocybe do not just flood the brain with serotonin. They target a
Psilocybe caerulescens- Landslide mushrooms
specific subtype of serotonin receptor—the 5-HT2A receptor—to which they bind directly,
The excitatory effects characterized by thereby activating it.
Following is a phase of tiredness and deep sleep, in which
elation, giddiness, hyperactivity, muscle
it may be difficult to arouse the patient. During this phase,
tremors, and distortion of space and time
vivid hallucinations and manic excitement may oscillate ⍾ The 5-HT2A receptor is known to play a key role in regulating mood, anxiety,
begin approximately 30 minutes to 2 hours
with periods of deep sleep. The duration of effect is up to schizophrenia and consciousness
after ingestion and are likely to be mediated
12 hours. Prolonged sleep withA. muscaria ingestion ⍾ Many trials- micro and macro dosing PTSD, OCD, Migraines, PD, Anxiety, Suicide etc.
by ibotenic acid.
requires only observation and supportive care. Tonic-clonic
seizures are reported, but occurrences are rare. ⍾ Hallucinogenic mushroom use found in the Sahara Desert and date back to 7000 to 9000 years ago.
⍾ Traditionally used by Mayans, aztec and many other native tribes throughout Mexico and California

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The Promise of Therapeutic Psilocybin: An Evaluation of the 134 Clinical Trials, 54

Potential Indications, and 0 Marketing Approvals on ClinicalTrials.gov

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The Rig Veda

Mushroom medicine Lindsay Chimileski ND Lac RH

SSRIs target the 5-ht1a receptor

Behavior and emotional responses,
regulating your hunger, thirst, response to Changes our tolerance to stress by
pain, levels of pleasure, sexual satisfaction, Encouraging patiences and emotional resistance
SSRIs target the 5-ht1a receptor anger and aggressive behavior
but it can BLUNTING
They help us TOLERATE stress.
Cope with things that are hard; grin and bear it
Anti stress/ pro coping

Psychedelics target the 5-ht2a receptor

Adapt and change
Outside of just the limbic system
Related to neuroplasticity
Environmental sensitivity
Learning and UNLEARNING
Adaption and change
Enhance sensitivity
Facilitate emotional release
Psychedelics target the 5-ht2a receptor Pro-therapeutic
a measure of the brain's
overall flexibility or —Not just grinning and bearing it; actually making space to adapt ourselves
Stoned Ape theory- role in development of language readiness to encounter
unpredictable stimuli and
or environments to impact change
—May be 1-3 or less frequent doses can have such lasting impact
Terrence McKenna they found that it 5-HT2A receptors are in the high level association regions of the brain
correlated with
influencing cognition, perception.
intelligence
—Lowest activity in the PMC or brain areas more connected to motor function

New Research on Ancient Mushrooms Lindsay Chimileski ND Lac RH MushWomb Medicine Lindsay Chimileski ND LAc RH(AHG)

l
ca
iti
cr
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https://ericazelfand.com/
Great trainings & resources

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20 patients, severe unipolar treatment-resistant

depression.
Two doses 1 week apart.

SINGLE DOSE psilocybin vs. single No negative side effects

Reduction in depressive symptoms for 5 weeks
dose niacin
post tx and 3, 6 month checks.

Follow ups showed improvements No one sought other treatment for depression
4.5 years after! first 5 weeks

Quality reports of the psychedelic experience

Anxiety, Depression, Hopelessness, predicted level and length of decrease in
Demoralization, depressive symptoms
Death Anxiety

Mushroom Medicine for Everyone. Lindsay Chimileski ND LAc RH(AHG) Medicinal Mushrooms Lindsay Chimileski ND Lac RH

12 healthy volunteers - 25mg/70kg(or 154.3 lbs) dose

Assessment 1 day before, 1 week after, 1 month after
More brain changes initially, still positive affect with reduced anxiety 1 month out
Resting-state functional connections across the brain increased
=influences emotional and brain plasticity, lightens negative affect

n=117
“Effects on anxiety and
depression were large and
statistically significant. No
serious adverse effects.”

Lindsay Chimileski ND LAc RH(AHG)

2 doses & long term/6 month follow up

51 cancer patients with life-threatening diagnoses and
symptoms of depression and/or anxiety.

This randomized, double-blind, cross-over trial investigated the effects of a very

low (placebo-like) dose (1 or 3 mg/70 kg) vs. a high dose (22 or 30 mg/70 kg) of
psilocybin administered in counterbalanced sequence with 5 weeks between
sessions and a 6-month follow-up.

High-dose psilocybin produced large decreases in clinician- and self-rated

measures of depressed mood and anxiety, along with increases in quality of life,
life meaning, and optimism, and decreases in death anxiety.

At 6-month follow-up, these changes were sustained, with about 80%

of participants continuing to show clinically significant decreases in
depressed mood and anxiety.

Participants attributed improvements in attitudes about life/self, mood,

relationships, and spirituality to the high-dose experience, with >80% endorsing
moderately or greater increased well-being/life satisfaction.

Community observer ratings showed corresponding changes. Mystical-type

psilocybin experience on session day mediated the effect of psilocybin dose on
therapeutic outcomes.
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Mushroom medicine Lindsay Chimileski ND Lac RH

Methods: This randomized, waiting-list controlled study enrolled 27 patients aged 21-75 with moderate to severe unipolar
depression (GRID-Hamilton Depression Rating Scale (GRID-HAMD) ⩾ 17). Participants were randomized to an immediate or
delayed (8 weeks) treatment condition in which they received two doses of psilocybin with supportive psychotherapy. Twenty-four
participants completed both psilocybin sessions and were followed through 12 months following their second dose.

Results: All 24 participants attended all follow-up visits through the 12-month timepoint. Large decreases from baseline in
GRID-HAMD scores were observed at 1-, 3-, 6-, and 12-month follow-up (Cohen d = 2.3, 2.0, 2.6, and 2.4, respectively).

Treatment response at 12 months:

(⩾50% reduction in GRID-HAMD score from baseline) 75%

Remission 58%, at 12 months.

There were no serious adverse events judged to be related to psilocybin in the long-term follow-up period, and no
participants reported psilocybin use outside of the context of the study.

Participant ratings of personal meaning, spiritual experience, and mystical experience after sessions predicted
increased well-being at 12 months, but did not predict improvement in depression.

Conclusions: These findings demonstrate that the substantial antidepressant effects of psilocybin-assisted therapy may be
durable at least through 12 months following acute intervention in some patients.

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Parkinson’s Disease
Abstract Psilocybin therapy shows antidepressant potential, but its therapeutic actions are not well understood. We assessed the subacute impact of psilocybin on brain
function in two clinical trials of depression.

1. Just Psilocybin: The first was an open-label trial of orally administered psilocybin (10 mg and 25 mg, 7 d apart) in patients with treatment-resistant depression.
Functional magnetic resonance imaging (fMRI) was recorded at baseline and 1 d after the 25-mg dose. Beck's depression inventory was the primary outcome
measure ( MR/J00460X/1 ).

2. Double-blind phase II randomized controlled trial comparing psilocybin therapy with escitalopram.

Patients with major depressive disorder received either 2 × 25 mg oral psilocybin, 3 weeks apart, plus 6 weeks of daily placebo ('psilocybin arm') or 2 × 1 mg oral
psilocybin, 3 weeks apart, plus 6 weeks of daily escitalopram (10-20 mg) ('escitalopram arm'). fMRI was recorded at baseline and 3 weeks after the second psilocybin
dose.

In both trials, the antidepressant response to psilocybin was rapid, sustained and correlated with
decreases in fMRI brain network modularity, implying that psilocybin's antidepressant action may
depend on a global increase in brain network integration.
Network cartography analyses indicated that 5-HT2A receptor-rich higher-order functional networks became more
functionally interconnected and flexible after psilocybin treatment.

The antidepressant response to escitalopram was milder and no changes in brain network organization
were observed. Consistent efficacy-related brain changes, correlating with robust antidepressant effects across two
studies, suggest an antidepressant mechanism for psilocybin therapy: global increases in brain network integration.
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MicroDosing

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OCD
Abstract Background: Anecdotal reports suggest that psychedelic agents may
relieve symptoms of obsessive-compulsive disorder (OCD).

This modified double-blind study investigated the safety, tolerability, and

clinical effects of psilocybin, a potent 5-HT(1A) and 5-HT(2A/2C) agonist, in
patients with OCD.

Method: Nine subjects with DSM-IV-defined OCD and no other current major psychiatric disorder participated in up to 4 single-dose exposures to
psilocybin in doses ranging from sub-hallucinogenic to frankly hallucinogenic. Low (100 microg/kg), medium (200 microg/kg), and high (300 microg/
kg) doses were assigned in that order, and a very low dose (25 microg/kg) was inserted randomly and in double-blind fashion at any time after the first
dose. Testing days were separated by at least 1 week. Each session was conducted over an 8-hour period in a controlled environment in an outpatient
clinic; subjects were then transferred to a psychiatric inpatient unit for overnight observation. the Yale-Brown Obsessive Compulsive Scale (YBOCS) and a visual
analog scale measuring overall obsessive-compulsive symptom severity were administered at 0, 4, 8, and 24 hours post-ingestion. The Hallucinogen Rating Scale was
administered at 8 hours, and vital signs were recorded at 0, 1, 4, 8, and 24 hours after ingestion. The study was conducted from November 2001 to November 2004.

Results: Nine subjects were administered a total of 29 psilocybin doses. One subject experienced transient hypertension without relation to anxiety or somatic symptoms,
but no other significant adverse effects were observed. Marked decreases in OCD symptoms of variable degrees were observed in all subjects
during 1 or more of the testing sessions (23%-100% decrease in YBOCS score).

Repeated-measures analysis of variance for all YBOCS values revealed a significant main effect of time on Wilks lambda (F = 9.86, df = 3,3; p = .046), but no significant effect
of dose (F = 2.25, df = 3,3; p = .261) or interaction of time and dose (F = 0.923, df = 9,45; p = .515). Improvement generally lasted past the 24-hour timepoint.

Conclusions: In a controlled clinical environment, psilocybin was safely used in subjects with OCD and was
associated with acute reductions in core OCD symptoms in several subjects.

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History of psychedelic use linked to decreased suicidal tendency

Those who did not use psychedelics in the past
And used opioids now, higher risk of suicide

Methods: Data (2010-2017) were drawn from a community-based, prospective open cohort of Objective: This study aimed to longitudinally investigate whether ever having used a psychedelic drug can have a
marginalized women in Vancouver, Canada. Extended Cox regression analyses examined the protective effect on incidence of suicidality among marginalised women. Design: Longitudinal community-based
moderating effect of psychedelic use on the association between other illicit drug use and incidence of cohort study. Setting: Data were drawn from a prospective, community-based cohort of marginalised women in Metro
suicidal ideation or attempt over follow-up. Vancouver, Canada.

Results: Of 340 women without suicidal ideation or attempt at baseline, 16% ( n=53) reported a first Participants: 766 women completed the baseline questionnaire between January 2010 and August 2014.
suicidal episode during follow-up, with an incidence density of 4.63 per 100 person-years (95% Participants who did not report suicidality at baseline and who completed at least one follow-up visit were included.
confidence interval 3.53-6.07). In unadjusted analysis, psychedelic use moderated the
relationship between prescription opioid use and suicide risk: Main outcome measure: Extended Cox regression was used to model predictors of new suicidality (suicide
ideation or attempts) over 54-month follow-up.
among women who did not use psychedelics, prescription opioid
Results: Nearly half (46%; n=355) of participants reported prior suicidality and were thus excluded from the present
use increased the hazard of suicide (hazard ratio 2.91; 95%
analyses. Of 290 women eligible at baseline, 11% (n=31) reported recent suicidality during follow-up,
confidence interval 1.40-6.03) with an incidence density of 4.42 per 100 person-years (95% CI 3.10 to 6.30).

whereas prescription opioid use was not associated with increased In multivariable analysis, reported lifetime psychedelic drug use was
suicidal ideation or attempt among those who used psychedelics associated with a 60% reduced hazard for suicidality (adjusted HR (AHR) 0.40;
(hazard ratio 0.69; 95% confidence interval 0.27-1.73) (interaction term p- 95% CI 0.17 to 0.94).
value: 0.016). The moderating effect of psychedelics remained
significant when adjusted for confounders (interaction term p-value: Crystal methamphetamine use (AHR 3.25; 95% CI 1.47 to 7.21) and childhood abuse
0.036). (AHR 3.54; 95% CI 1.49 to 8.40) remained independent predictors of suicidality.

Conclusions: Psychedelic use had a protective moderating effect on the Conclusion: The high rate of suicidality identified in this study is of major concern.
relationship between prescription opioid use and suicide risk. In the context Alongside emerging evidence on the potential of psychedelic-assisted therapy to treat
of a severe public health crisis around prescription opioids and lack of some mental illness and addiction issues, our findings demonstrate that naturalistic
addiction services tailored to marginalized women, this study supports calls psychedelic drug use is independently associated with reduced suicidality, while other
for innovative, evidence-based and trauma-informed interventions, including illicit drug use and childhood trauma predispose women to suicidality. While
further research on the potential benefits of psychedelics observational, this study supports calls for further investigation of the therapeutic utility of
psychedelic drugs in treating poor mental health and promoting mental wellness.
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mTOR action directly related to psychedelic-induced

neuritogenesis, suggesting that BDNF and psychedelics
possess a shared mechanism for promoting neuritogenesis
through an mTOR-related process of protein synthesis in
synaptogenesis
Abstract
With a rise in the incidence of autoimmune diseases (AiD), health care providers 2.1. The link between autoimmunity and mental disorders Likely directly related to 5-HT2A
continue to seek out more efficacious treatment approaches for the AiD patient The comorbidity between autoimmune conditions and mental and mood receptor agonist activity of classic psychedelics, given that
population. Classic serotonergic psychedelics have recently been gaining public and disorders, such as MDD, anxiety, schizophrenia, and bipolar disorder has when ketanserin, a 5-HT2A antagonist, is administered the
professional interest as novel interventions to a number of mental health afflictions. neuroplastic effects of DMT, LSD, and DOI are gone
become apparent in the last two decades [8,[23], [24], [25]]. There is a higher
Psychedelics have also been shown to be able to modulate immune
risk of developing clinical depression or mood disorders if one has been
functions, however, while there has been great interest to researching
into their psychotherapeutic applications, there has so far been very little diagnosed with an autoimmune condition [24]. While there is certainly Shown potential in interacting with neurogenic
exploration into the potential to treat inflammatory and immune-related argument that the burden of having an autoimmune condition could pathways, such as Tropomyosin receptor kinase B
diseases with these compounds contribute to MDD, researchers suggest that depression and anxiety (Trk-B) and (mTOR) (the mammalian target of
A handful of studies from a variety of fields suggest that psychedelics do symptoms could perhaps be a result of autoimmune mechanisms rapamycin), in an equivalent manner to
indeed have effects in the body that may attenuate the outcome of AiD. and resulting inflammation occurring in the nervous system, the neurotrophin protein brain-derived
or via dysregulated inflammatory cytokine loops between neurotrophic factor (BDNF)
This literature review explores existing evidence that psychedelic compounds may
peripheral and brain-resident immune cells [11,26]. Potentially by
offer a potential novel application in the treatment of pathologies related to
autoimmunity. their immunomodulatory activity and in part through the mobilization of
We propose that psychedelics hold the potential to attenuate or even cell-intrinsic neuroprotective mechanisms, psychedelics may
resolve autoimmunity by targeting psychosomatic origins, maladaptive represent a promising intervention for autoimmune-related
chronic stress responses, inflammatory pathways, immune modulation depression and other mental illness.
and enteric microbiome populations.

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Abstract

Background: A recent open-label pilot study (N = 15) found that two to three moderate to high
doses (20 and 30 mg/70 kg) of the serotonin 2A receptor agonist, psilocybin, in combination
with cognitive behavioral therapy (CBT) for smoking cessation, resulted in
substantially higher 6-month smoking abstinence rates than are typically
observed with other medications or CBT alone.
Addiction and alcohol misuse disorders
Objectives: To assess long-term effects of a psilocybin-facilitated smoking cessation program at
343 respondents, mostly White (89%), males (78%), in the USA (60%) ≥12 months after psilocybin administration.
completed the survey.
Methods: The present report describes biologically verified smoking abstinence outcomes of the
Participants reported seven years of problematic alcohol use on average before previous pilot study at ≥12 months, and related data on subjective effects of psilocybin.
the psychedelic experience to which they attributed reduced alcohol
Results: All 15 participants completed a 12-month follow-up, and 12 (80%) returned for a
consumption, with 72% meeting retrospective criteria for severe AUD.
long-term (≥16 months) follow-up, with a mean interval of 30 months (range = 16-57 months)
Most reported taking a moderate or high dose of LSD (38%) or psilocybin (36%), between target-quit date (i.e., first psilocybin session) and long-term follow-up. At 12-month follow-
followed by significant reduction in alcohol consumption. up, 10 participants (67%) were confirmed as smoking abstinent. At long-term follow-up, nine They sell Nicotine gum and patch as
After the psychedelic experience 83% no longer met AUD criteria. participants (60%) were confirmed as smoking abstinent. At 12-month follow-up 13 “statistically significant” at 6-15%! and you
participants (86.7%) rated their psilocybin experiences among the five most
Participants rated their psychedelic experience as highly meaningful have to keep using them as replacement
personally meaningful and spiritually significant experiences of their lives.
and insightful, with 28% endorsing psychedelic-associated changes
vs.
in life priorities or values as facilitating reduced alcohol misuse. Conclusion: These results suggest that in the context of a structured treatment program,
Greater psychedelic dose, insight, mystical-type effects, and personal meaning psilocybin holds considerable promise in promoting long-term smoking abstinence. The present 2-3 high doses with CBT
of experiences were associated with a greater reduction in alcohol
study adds to recent and historical evidence suggesting high success rates when using classic
psychedelics in the treatment of addiction. Further research investigating psilocybin-facilitated
Psilocybin and CBT therapy =
consumption, controlling for prior alcohol consumption and related distress treatment of substance use disorders is warranted. 60% smoking abstinent
Teachers to heal a broken society
MushWomb Medicine Lindsay Chimileski ND LAc RH(AHG)
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Mushrooms reset apathy to help us be more connected & empathetic humans

Abstract
Abstract
Background: Recent evidence suggests that psychedelic use predicts reduced perpetration of intimate partner violence among men
Recent evidence indicates that psilocybin with psychological support may be effective for treating depression. Some studies have found that patients involved in the criminal justice system. However, the extent to which this association generalizes to community samples has not been
examined, and potential mechanisms underlying this association have not been directly explored.
with depression show heightened amygdala responses to fearful faces and there is reliable evidence that treatment with SSRIs attenuates amygdala
Aims: The present study examined the association between lifetime psychedelic use and intimate partner violence among a community
responses (Ma, 2015). We hypothesized that amygdala responses to emotional faces would be altered post-treatment with psilocybin. In this open-label sample of men and women. The study also tested the extent to which the associations were mediated by improved emotion regulation.
study, 20 individuals diagnosed with moderate to severe, treatment-resistant depression, underwent two separate dosing sessions
Methods: We surveyed 1266 community members aged 16-70 (mean age=22.78, standard
with psilocybin. deviation =7.71) using an online questionnaire that queried substance use, emotional regulation, and
intimate partner violence. Respondents were coded as psychedelic users if they reported one or more TOOLS FOR
Psychological support was provided before, during and after these sessions and 19 completed fMRI scans one week prior to the first instance of using lysergic acid diethylamide and/or psilocybin mushrooms in their lifetime. Results/ BETTER
session and one day after the second and last. outcomes: Males reporting any experience using lysergic acid diethylamide and/or EMOTIONAL
psilocybin mushrooms had decreased odds of perpetrating physical violence REGULATION
Neutral, fearful and happy faces were presented in the scanner and analyses focused on the amygdala. against their current partner (odds ratio=0.42, p<0.05).
To help our men
Group results revealed rapid and enduring improvements in depressive symptoms post psilocybin. Increased responses to fearful Furthermore, our analyses revealed that male psychedelic users reported better
and happy faces were observed in the right amygdala post-treatment, and right amygdala increases to fearful versus neutral faces emotion regulation when compared to males with no history of psychedelic use. To help our women
were predictive of clinical improvements at 1-week. Better emotion regulation mediated the relationship between psychedelic use and
lower perpetration of intimate partner violence. This relationship did not extend to females
Psilocybin with psychological support was associated with increased amygdala within our sample. Better regulated
Conclusions/interpretation: These findings extend prior research showing a negative relationship society?!
responses to emotional stimuli, an opposite effect to previous findings with SSRIs. between psychedelic use and intimate partner violence, and highlight the potential role of emotion
regulation in this association. Less violence and
This suggests fundamental differences in these treatments' therapeutic actions, with SSRIs mitigating negative emotions and psilocybin crime for all
allowing patients to confront and work through them. Based on the present results, we propose that psilocybin with psychological support is a
treatment approach that potentially revives emotional responsiveness in depression, enabling patients to reconnect with their emotions. Teachers to heal a broken society
Fungi Wisdom Apprenticeship. Lindsay Chimileski ND LAc RH(AHG) MushWomb Medicine Lindsay Chimileski ND LAc RH(AHG)

Silo Pharma’s drug – SPU-21, arthritogenic joint homing peptides utilizing

psilocybin – has demonstrated it significantly inhibited arthritic progression
in the animal model, and the company is carrying out further studies at UMB.

Cybin, a Canadian life sciences startup focused on

developing psychedelic pharmaceutical products to treat mental disorders,
raised 45 million Canadian Dollars ($34 million) in a private placement,

Stamets is patenting
using Psilocybin with
lions mane and niacin

https://psychedelichealth.co.uk/2022/06/24/silo-pharma-to-utilise-psilocybin-for-autoimmune-diseases/

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Subjects maintained headache diaries starting 2 weeks before the first session until 2 weeks
after the second session. Physiological and psychological drug effects were monitored during
sessions and several follow-up contacts with subjects were carried out to assure safety of study
procedures.

Ten subjects were included in the final analysis. Over the 2-week period measured after
single administration, the reduction in weekly migraine days from baseline was
significantly greater after psilocybin (mean, - 1.65 (95% CI: - 2.53 to - 0.77) days/week)
than after placebo (- 0.15 (- 1.13 to 0.83) days/week; p = 0.003, t(9) = 4.11). Changes in
Abstract migraine frequency in the 2 weeks after psilocybin were not correlated with the intensity of
! The development of chronic pain is a complex mechanism that is still not fully understood. Multiple somatic and acute psychotropic effects during drug administration.
Psilocybin was well-tolerated; there were no unexpected or serious adverse events or
visceral afferent pain signals, when experienced over time, cause a strengthening of certain neural circuitry through
withdrawals due to adverse events. This exploratory study suggests there is an enduring
peripheral and central sensitization, resulting in the physical and emotional perceptual chronic pain experience. therapeutic effect in migraine headache after a single administration of psilocybin.
! The mind-altering qualities of psychedelics have been attributed, through serotonin 2A (5-HT2A) receptor agonism, Migraine Frequency (note negative bars- placebo
barely decreased frequency, while psilocybin
to 'reset' areas of functional connectivity (FC) in the brain that play prominent roles in many central neuropathic states. Time passed before next migraine extended with Psilo
decreases it by almost 2 days)
! Psychedelic substances have a generally favorable safety profile, especially when compared with opioid analgesics.
! Clinical evidence to date for their use for chronic pain is limited; however, several studies and reports over the past
50 years have shown potential analgesic benefit in cancer pain, phantom limb pain and cluster headache.
! While the mechanisms by which the classic psychedelics may provide analgesia are not clear, several possibilities
exist given the similarity between 5-HT2A activation pathways of psychedelics and the nociceptive modulation
pathways in humans.
! Additionally, the alterations in FC seen with psychedelic use suggest a way that these agents could help reverse the
changes in neural connections seen in chronic pain states.
! Given the current state of the opioid epidemic and limited efficacy of non-opioid analgesics, it is time to consider
further research on psychedelics as analgesics in order to improve the lives of patients with chronic pain conditions.

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14 final participants
In the 3 weeks after the start of the pulse regimen, the change in cluster attack frequency was

Placebo 0.03 (95% confidence interval [CI] -2.6 to 2.6) attacks/week (baseline 8.9 [95% CI 3.8 to Many surveys style studies gauging specific
14.0])
populations experience and interest in participating
Psilocybin-3.2 (95% CI -8.3 to 1.9) attacks/week with (baseline 9.6 [95% CI 5.6 to 13.6]; p = 0.251). psychedelic trials for their condition
Group difference in change from baseline had a moderate effect size (d = 0.69). The effect size was
small in episodic participants (d = 0.35) but large in chronic participants (d = 1.25), which remained Abstract Fibromyalgia (FM) is a difficult to treat chronic pain condition for which there is strong interest in alternative treatments. There
over the entire 8-week period measured (d = 0.81). is growing interest in the potential of psychedelic substances (e.g., psilocybin) in conjunction with psychotherapy to treat chronic pain.
Via a cross-sectional, anonymous, online survey, we aimed to characterize knowledge, perceptions, and past use of serotonergic
("classic") and non-serotonergic psychedelics among a population of individuals with FM, and to investigate interest in psychedelic-
Changes in cluster attack frequency were not correlated with the intensity of acute based FM treatments.
psychotropic effects during psilocybin administration. Psilocybin was well-tolerated
without any unexpected or serious adverse events. Among a North American population of 354 participants with FM, 29.9% reported past use of a psychedelic, with lysergic
acid diethylamide (LSD) and psilocybin mushrooms being most commonly used.

Perceptions of benefit from psychedelic use were generally neutral (59.4%) or positive (36.8%), with <3% reporting negative impacts
on overall health or pain symptoms.

Among 12 participants who used psychedelics with intentions of treating chronic pain, 11 reported improved
symptoms.

Regardless of past use, the majority of participants believed that psychedelics have potential for chronic pain treatments and would be
willing to participate in a psychedelic-based clinical trial for their pain. These findings support the need for additional studies to
understand the potential and effectiveness of psychedelic substances in managing FM symptoms.

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Psychedelic Micro Dose, Harm Reduction and Integration Information & Resources zendoproject
Micro dose Mushroom Range: 0.1-0.5g
Create a safe space
Microdose.me Sitting, not guiding
Microdosingsurvery.com
Talking through, not down
Month of, followed by break periods. Difficult is not necessarily bad
Fadiman Method 1 day on, 2 days off for
Stamets 4 days on, 3 days off
Flight Instructions
Encourage exploration within the visions
Stamets Stack [and trip sitters to ensure safe physical environment]

Introspection into your day / journaling/ surveys of your experience Allow yourself to see what the medicine is showing you

1. If you see a door, open it

Integration Counseling and Journal Prompts 2. If you see a staircase go up or down it
3. If you feel like you see a monster, face it instead of running
4. Remember to breathe
Working with therapist/support team ongoingly etc.

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Medicinal Mushroom Dosing

is going to vary greatly depending on your
goals and the extraction forms you are using.

Price, digestion are the main limiting factors,

very safe. Minimal digestive upset usually
only adverse reaction. Chinese Pharmacopoeia Doses
Maitake 2 to 25 grams of whole powder daily.
Whole mushroom powder doses or dried
Oysters: 3-9 grams daily
range from 2 to 16 to 50 grams in divided
doses. At least 6g in most for therapeutic Chaga: Powder is 1-3grams daily
dose.
Resihi 6 to 12 grams daily
All of our medicinal mushrooms are going to touch on these
Can be prescribed as a tea, soup or food (fresh or dried) too! Lion’s Mane: 25-50grams daily
250-750mg used in trials for cognitive function. 3-5g used in clinical trials, 5g fruiting body
in soup. 500mg/kg.
mechanisms—due to shared basic polysaccharides,
Tinctures, Standardized extracts can be dosed lower but more
often than not, the goal is still to get to high doses when Phellinus linteus: 30grams daily dried, if polysaccharide extract 2-3g/
antioxidants, minerals, triterpenoids and vitamins.
really using mushrooms as a targeted therapy. Still will be day is common. Of course there are some nuances to it and specific indications but in general they
beneficial at lower doses though, just more for vitality,
wellness, prevention side. Shiitake: 6–16 grams; fresh-about 90 grams ALL will help brain health.

Doses from Christopher Hobbs Medicinal Mushrooms III, drugs.com medication database and the Chinese pharmacopoeia

Likely the most famous Mexican healer to have ever lived. Her history and reputation led her to serve as a bridge between
the mystical and ritual worlds of her people, and the mystical exploration of the Western world.
Born into the Mazatec ethnic group in 1894, she came from a small town called Huautla de Jiménez, in the Sierra de Oaxaca,
located in southern Mexico. Her father’s family had already included several shamans. From a very young age, contact with them
brought her closer to the region’s traditional ceremonies, which included the intake of hallucinogenic mushrooms (know as
“holy children”) as a method of contact with divinity. She first tried the mushrooms at the age of eight. It’s said that she
intuitively developed a knowledge of the rituals and their healing power which, in her culture, was attributed to these
mushrooms.
Among the Mazatec people, the most common healing method since prior to the colonial period, was the ritual intake of fungi of
a species called Mexican Psilocybe and which grow only in a particular mountain range. When visited by someone with some
physical or spiritual condition, Sabina served as a guide on the patient’s journey to, and return from, spiritual
realms (along with a cure for the illness). To Sabina, mushrooms were an instrument for connecting dimensions
and realities that happen in parallel. Because of their peculiarity, intensity, and various reports of effectiveness,
Sabina’s healing sessions became very popular in the Mexico of the early 1950s.
Sabina’s total dedication to the healing practice began around the middle of her life during that same decade. Her healing
ceremonies with fungi included Mazatec chants, tobacco smoke, mezcal consumption, and ointments extracted from medicinal
plants. Such rituals were made at night, for it was at this hour that healer was accompanied and guided by the stars to the
kingdoms of the afterlife.
Over time, the story of Maria Sabina, her fame, and her mystery, caught the attention of media and personalities from many parts
of the world and from other disciplines. One of the first was an American, Robert Gordon Wasson, an economist by
profession, best known for his studies in ethnobotany (the interaction between humans and plants). These he
made with his wife, Valentina Pavlovna Guercken. Among their various interests was the use of hallucinogenic plants in
the rituals of ethnic groups from different parts of the world. Their interest led the couple to visit the Mazatec Sierra on several
occasions, and here they heard of the famous healer from Huautla.
In 1955, Wasson and his wife convinced Sabina to receive them. Guided by her, they conducted several
“veladas” (vigils) with the fungi, and they documented the entire experience in photos and recordings. They
also obtained research samples of the fungi used in the sessions. Two years later, in 1957, an article written by
Wasson was published in Life magazine. The text, accompanied by the images, described the research and
chronicled the couple’s experiences with Sabina. After its publication, visits by people from all over the world to
the healer only multiplied. She was famous. In 1968, Wasson published the book The Wondrous Mushroom:
Mycolatry in Mesoamerica in which he revealed in detail the fruits of his mycological and anthropological

María Sabina Magdalena García research in Mexico. Within this text, the main character is Sabina. At the time in the United States, the hippie
movement —ever interested in psychedelia and its accompanying mystique— was at its cusp. This influenced the book’s
enormous popularity.
known as the “priestess of mushrooms,”
Domestic and foreign visits increased still further. Many of these visitors were interested purely in psychedelic
recreational pursuits. They obviated the history of the ancient practices, and lost respect for the culture and
religion of the Mazatec people. This displeased members of Sabina’s community who argued that she was
profiting from their tradition. Huautla de Jiménez was now constantly receiving national and foreign media figures, tourists,
artists, intellectuals, anthropologists, researchers, and celebrities. Among them, one might find Aldous Huxley, Alejandro
Artist: Rosenfeld Rafti Jodorowski, Carlos Castaneda, Albert Hofmann, John Lennon and Walt Disney.

MushWomb Medicine Lindsay Chimileski ND LAc RH(AHG)

Full story: www.faena.com/aleph/maria-sabina-a-most-fascinating-mexican-healer

Eat more mushrooms!

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 2025 Medicines from the Earth Disaster Herbalism - Coffman

POST-DISASTER SITUATION: Cat 4 Hurricane relief effort, gulf coast

HERBALISM • Location – Houston, TX

• Help needed ASAP
Providing Clinical Herbal Care • Current weather: light winds, partly
in cloudy, low’s 40-50 deg F, highs 80-90
deg F

Austere and Remote • Limited to no power in most areas

• Limited clean water
Environments
• Limited gasoline availability

Step 1: Information Gathering Step 1: Information Gathering

• What do we need to know (continued)?
• What do we need to know?
• Security issues
• Access – ingress, egress (i.e. boat, 4WD only, OHV, Bicycle, Foot) • Physical safety (i.e. damaged buildings, infrastructure)
• Construction timelines for access (i.e. bridges or roads down) • Crime
• Operational health care facilities • Law enforcement availability
• Level (esp. trauma) • Level of social cooperation or unrest

• Accessibility and Transport • Cultural (e.g., language, religion, etc.)

• Red Cross, FEMA and other medical aid groups • How do we find out?
• Epidemiology • HAM (ARES)
• Trauma • FEMA app
• Environmental • Social media
• Medical • Ready.gov
• Acute • Google Crisis Maps
• Chronic • Apps for families, friends (e.g., Life360, GoogleMap Share, etc.)

Step 2: Preparation Step 2: Preparation

• People • Resources/Supplies
• How many people do we have? • Transportation
• Spontaneous • Communication
• Roster • Security
• What roles can they fill? • Food
• Scout • Water
• Medic
• Shelter
• Dispatch/information gathering
• Medicine
• Provider
• Off-grid engineer

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Step 2: Preparation Step 2: Preparation

• Transportation • Communication
• Shuttling (vehicles)? • Cell phones?
• Caravan? • Text
• Meetup point? • PTT Apps (i.e. Zello)
• Staging area(s)? • FRS/GMRS/MURS/CB?
• HAM radio?
• Fuel?
• Dispatch
• Organization/leadership
• Roster
• Some form of tracking for all team
members
• Regular check-ins

Step 2: Preparation
• Security
Step 2: Preparation
• Staging house(s)
• Team briefings (e.g., buddy teams, social behavior, • Shelter
valuables)
• Personal shelter – staging area (e.g., personal
• Rally point(s)
• Personal security (e.g., alerts, etc.)
house, public building allocated for team, etc.)

• Food
• Clinic shelter
• Individual vs. Team meals • Existing (safe) structures?
• Team members have basic and comfort food • Mobile?
• General provider schedule (e.g., food preparation, team • Temporary/field expedient?
medic)
• Floor, roof, dividers, tables, chairs
• Water
• Similar to food – team members have basic water
purification and containers
• Team water available (showers, hygiene, refilling personal
supplies)

Step 2: Preparation
Step 3: Finances
• Medicine • Covering all costs in Step 2 (Preparation)
• Start with the amount that can be transported (or, • Out of pocket financing
if less than that – the amount available) • Donations (cash, herbs, in-kind, etc.)
• Can any be mailed or transported separately? • Fundraising (e.g., events, auctions, etc.)
(e.g., donations, etc.)
• Crowd-funding (e.g., gofundme)
• Does it make sense to make medicine on-site?
• Social media
• Back to epidemiology of the situation and area(s)
• Student or customer base (i.e., “10% of every
• Baseline of standard formulas sale…”)
• Simples

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 2025 Medicines from the Earth Disaster Herbalism - Coffman

Step 4: Materials Prep Step 4: Materials Prep

• Total max amount
• Medicine making
• Can be from total max amount that can be
• Collection points (for both medical and non- transported in:
medical donations) • Example: Total max amount = 100 gallons of fluid-
based extraction – roughly 1,000 pounds
• Amount and types of medicine
• Alcohol? • Or total amount of max expected clinical patients
• Topical? • 100 clinical patients per day
• 2 x 2-ounce formulas per patient average = 4 x 100 =
• Most common issues to plan for? 400 ounces / 16 = 25 gallons per day of extracts x 10
• Max expected clinical visitors (if no idea, what days = 250 gallons of extracts
is the max number you could treat?) • How do you divide out the herbs and formulas?
• First aid? • Our solution – 10 – 15 base formulas
• Base Formulas? • 40-50 simples
• Simples?

Step 4: Materials Prep Step 4: Materials Prep

Step 5: Deployment Containers, Formulas and Herbs

• Travel and Communications plan
• Containers are key
• Dispatch is incredibly helpful • Stacking totes
• Meeting places (rally points) • Plastic (HDPE)
• Enroute/Prior
• Nalgene
• Enroute/Post
• Food grade plastic containers
• Emergency rally points
• PTE – lighter and cheaper than HDPE but less durable
• Be over-conservative on travel and deployment
• Avoid Glass
times
• Labeling
• Provider role helps here to make sure everyone is
• Alphabetized by genus
taking care of themselves, has food, water, any
medical needs taken care of • Blank labels for patients

• Scout team in advance (2-3 people) is ideal • Apothecary equipment – ideally always look for a
kitchen to host apothecary in
• Set up the location for the next day
• Portable totes can work in waterless environments

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 2025 Medicines from the Earth Disaster Herbalism - Coffman

Echinacea (angustifolia and purpurea mix)

Algerita (root + leaf) (Berberis triofoliolata)
Containers, Formulas and Herbs Chaparral (Larrea tridentata)
• Base Formulas
Cold & Flu Formula
• Respiratory
Lymph Formula
• Gut
UTI Formula
• Urinary Tract
Neuro-Regen Formula
• Cardiovascular Anti-helminthic/Protozoan Formula
• Integumentary Analgesic Formula
• HEENT (usually upper respiratory – possibly different Nervine Formula
administration methods)
Deep Anti-Infective Formula
• Musculoskeletal
Digestive Aid Formula
• Immune/Lymph
• CNS
Upper Respiratory Infection Formula
• Anti-bacterial (including biofilm)
Wound Powder
• Anti-protozoal
Burn Powder
• Anti-helminthic Skin Repair Salve
• “Anti-viral” Anti-Bacterial & Tissue Healing Salve
Sprain and Strain Liniment or Salve
Charcoal

Containers, Formulas and Herbs

• Herbs
• Largely depends on how you like to formulate
• What specific formulas do you already have?
• What are the herbs that are the most adaptable to the widest variety of symptoms?
• TCM Formulas
• I normally use TCM approaches more for chronic conditions
• Some TCM herbs work very well in western approaches also (ex: Myelin sheath regenerative herbs for neuro-
related issues)
• Think more in terms of being able to substitute as you run out of one simple

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 2025 Medicines from the Earth Wound and Infection - Coffman

Sam Coffman Herbal First Aid – Wound

Wound Management & Infection Control Healing
First: First Aid
Treat every wound in the field AS IF it were
life-threatening
A
S
I
F

Herbal First Aid – Wound Herbal First Aid – Wound

Healing Healing
Amount of bleeding or blood loss
Amount of bleeding or blood loss
Shock
Irrigation
Further or Functional Damage

Herbal First Aid – Shock Herbal First Aid – Shock

Shock Assuming the worst case (unknown
• Hypovolemic person and accident)
• Introduce yourself and give brief
• Cardiogenic background in one sentence
• Neurogenic • Ask permission to help
• Ask name, injury related questions
• Anaphylactic
• Be sincere and let them know you are
• Psychogenic there to help.
• Treat Injury
• Keep them warm & comfortable!

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 2025 Medicines from the Earth Wound and Infection - Coffman

Herbal First Aid – Irrigation Herbal First Aid – Functional

• Clean or Sterile Saline or Clean Water Damage
• Clean or Sterile Saline or Clean Water
• Pressure
• Pressure
• Location
• Visualization & • Location
• Visualization &
moving into:
moving into:
Functional or
Functional or
Further Damage
Further Damage

4 Stages of Wound healing Three Phases (after

• Hemostasis hemostasis)
• Inflammation
• Proliferation
• Remodeling

Spectrum of Wound Healing Classifications of Wound

Closure

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 2025 Medicines from the Earth Wound and Infection - Coffman

Orthodox Closure Orthodox

Techniques Closure
Techniques
Type of Wound Closure Advantages Disadvantages
Sutures Meticulous closure Greatest tissue reactivity
Strong (tensile strength) May require removal
Lowest dehiscence %
Staples Lowest tissue reactivity Lower meticulous closure
Low cost Imaging interference
Rapid application
Wound adhesives Patient comfort Lower tensile strength (usually)
Resistance to bacterial growth Greater dehiscence % (depending
No removal methods required on brand)
Not around joints or high tension
Not around mucosa/moist areas
Not jagged or avulsions
Sensitivity/Allergy
Strips (+ tincture of Benzoin) Patient comfort Highest dehiscence %
Low cost Lower tensile strength
Lowest infection rates Less effective when wet
Easy to use in conjunction with Cannot use around hair (shave)
topical phytotherapy

Plant Medicine Goals 1. Wound Cleaning

• Phytotherapeutic approaches – both • Irrigation
singularly and as adjuvant/integrative care •
•
Activated charcoal (USP food grade preferred)
Opuntia spp. (Prickly Pear)
to assist with: • Calcium bentonite (e.g. green clay)

– Reducing tissue inflammation (i.e. speeding

up inflammation phase)
– Immune and lymph support
– Infection management
– Antibiotic-resistant bacterial infections
– Biofilm inhibition
– Increasing tissue proliferation

Basics – Infection 2. Inflammation vs. Infection

• Hemostasis Infection Inflammation Infection
Specific Pain
• Inflammation Exudate Redness Bright red
Bright Redness
• Proliferation Streaking (Lymphangitis)
Swelling Specific swelling (i.e. abscess)
Local (Cellulitis) Pain Specific pain location
• Remodeling Systemic (Fever)
Non-Healing (Chronic) Decreasing symptoms with time Streaking (lymphangitis)

Cellulitis (waxy red sheen, increasing

pain)
Exudate (sanguinous to purulent)

Systemic signs (i.e. fever)

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 2025 Medicines from the Earth Wound and Infection - Coffman

Cellulitis Lymphangitis

Wound Colors Wound Exudate

• Red – healthy, good blood flow (in the wound bed • Serous – thin clear “watery” plasma Normal in the
itself) acute inflammatory stage (Moderate to heavy amount
• Pink - Epithelializing may indicate heavy bio-burden or chronicity due to
• Pale pink – poor blood flow; ischemia, anemia infection)
• Purple – engorged; edema; excessive bioburden; • Sanguinous – bloody (fresh bleeding) seen in deep
trauma (usually deep wounds, lack of perfusion over partial thickness & full thickness wounds during
time) angiogenesis. Small amount normal in the acute
inflammatory stage.
• Black or brown – nonviable, necrotic tissue
• Serosanguineous- thin, watery, pale red to pink, plasma
• Yellow – nonviable, necrotic tissue (slough) with RBC‘s. Small amount normal in acute
• Gray – nonviable, necrotic tissue inflammatory stage
• Green – infection; nonviable tissue • Purulent – thick, opaque, tan, yellow, green or brown
• White – ischemia; maceration (too much moisture), color, never normal in wound
may also be confused with bone or fascia

Wound Tunneling Wound Tunneling

• Infection à tissue destruction
• Dehydrated wound (wound dressing)
• Pressure/shear on the wound
• Steroids and NSAIDS
• Diabetes
• Extended inflammation period
• Inadequate wound packing
• Biofilms

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 2025 Medicines from the Earth Wound and Infection - Coffman

Wound Tunneling Wound Packing

Orthodox Approaches
• Reduce/Eliminate causes
• Wound care and cleansing
• Wound Packing
• Encourage granulation
• Remove pressure/weight bearing on wound

Wound Tunneling Acute vs. Chronic Wound

Herbal Approaches
Washes Packing Infection (Topical – Can be
in wash as well)
Oak Charcoal Echinacea

Heartsease Prickly Pear Berberine-Containing Herbs

Oregon Grape (leaf + root) Chaparral Baikal Skullcap

Calendula Fomentation packing Black Walnut

- Oak
Red Sage - Black Walnut Chaparral
- Calendula
Black Walnut Andrographis
- Red Sage

Lymph Capillaries & Factors Affecting Wound Healing

Microcirculation Infection
Local General
Nutritional deficiency
Ischemia Age
Foreign bodies Condition
Iatrogenic stress (e.g. rough tissue Liver disease
handling)
Lack of circulation Diabetes
Neoplasia Neoplasia
Steroids Chemotherapy
Radiation Steroids (immune suppression)

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 2025 Medicines from the Earth Wound and Infection - Coffman

Goals Preparations & Applications

• Phytotherapeutic approaches – both • Rinses & Soaks
singularly and as adjuvant/integrative care • Compresses
to assist with: • Poultices
– Reducing tissue inflammation • Plasters
– Increasing tissue proliferation • Salves
– Wound infection • Oils
• Liniments
– Chronic (non-healing) wounds
• Wraps
– Antibiotic-resistant bacterial infections
• Washes

Efflux Pump Inhibition Biofilms

• Berberine + 5’ Methoxyhydnocarpin (MHC) • Planktonic
– NorA MDR (efflux) pump, most specific to • Micro colonies ,
excrete
Staphylococcus (esp. MRSA) infections extracellular
– Berberidiceae (Barberry species, Oregon Grape) polymeric
– Hydrastis canadensis (Goldenseal) substances (EPS).
• Biofilm formed
• Capsaicin + Cipro tests • Maturation
• Critical Mass -
Recolonization

Biofilm Management Biofilm Management

• Quorum Sensing Inhibition (QSI) Quorum Sensing Disruption
– Baicalin Punica granatum (Pomegranate rind) Andrographis panniculata
• Plantago spp. (Plantain) (Andrographis)
• Scutellaria baicalensis (Baikal skullcap)
Achyranthes aspera (Chaff Flower) Taraxacum officinale (leaf)
– Arctostaphylos uva ursi (Dandelion)
– Juglans spp.
Archtystapholos uva ursi (Bearberry) Parkinsonia aculeata (Ratama)
– Commiphora spp.
Scutellaria baicalensis (Baikal Quercus spp. (Oak)
Skullcap)

Rosmarinus officinalis (Rosemary) Terminalia catappa (Indian Almond)

Hamamelis virginiana (Witch Hazel) Commiphora spp. (Myrrh)

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 2025 Medicines from the Earth Wound and Infection - Coffman

Proliferation Wound Healing Protocols

Collagen-Fibrin Matrix Formation
• Larrea spp. (Chaparral) – External Only Infection Inflammation Proliferation Remodeling
• Lantana spp. (Lantana) – External Only Management
• Centella asiatica (Gotu Kola) – External and Internal Charcoal Prunella vulgaris Larrea spp. Castor oil + Coconut
(cleaning) oil (1:1)
• Achillea spp. (Yarrow) – External and Internal
• Vitamin C (Internal) - Internal Opuntia spp. Astragalus Symphytum off.
Infused with
(cleaning) membranaceous
• Carica papaya (Unripe Papaya fruit) – External Only
• Equisetum spp. (Horsetail) Juglans spp. Ginkgo biloba Plantago spp. • Centella asiatica
• Symphytum off. (Comfrey)
Echinacea purpurea Centella asiatica Centella asiatica • Caspicum anuum
+ angustifolia
• Zanthoxylum
Berberine- Salvia miltiorrhiza Lantana camara, spp.
containing herbs urticoides
Quercus spp. + Angelica sinensis Achillea spp. • Vitamin E Oil
Pomegranate rind
Larrea spp. Achyranthes Vit C.
bidentata

Lymph & Herbs Lymph & Herbs

• Stressors • Innate
• Lifestyle (uncompensated stress) • Eupatorium perfoliatum - Boneset
• Nutrition • Echinacea spp.
• Sleep • Lymph
• Innate • Phytolacca americana - Poke
• Stimulate WBC count • Iris versicolor – Blue Flag
• Stimulate WBC activity • Ceanothus spp. – Red Root, New Jersey Tea
• Lymph • Trifolium pratense – Red Clover
• Increase flow and activity of lymph & nodes • Galium aparine – Cleavers
• Adaptive • Fouquieria splendens – Ocotillo
• Increase B Cell and T Cell Counts and Activity • Stillingia – Queen’s Delight
• Adaptive
• Maitake, Shiitake, Cordyceps
• Aziridachta indica - Neem
• Astragalus membranaceous

Key Formula Concepts Lymph Formula (acute)

↑ Lymph & ↑ Proliferation (granulation Strengthen & Support Veins What do we want to accomplish?
Microcirculation & epithelialization)
Phytolacca americana Larrea spp. Alchemilla vulgaris Increase WBC Increase Lymph Liver Support Eliminition
Count & Activity Flow/ Activity (Urinary)
Increase
Salvia miltiorrhiza Symphytum off. Achillia millefolium
Adaptive
Immunity
Zanthoxylum spp. Calendula off. Ruscus aculeatus Echinacea spp. Phytolacca a. Arctium lappa Arctium lappa
Eupatorium Iris versicolor Rumex crispus Taraxacum off.
Foquiera splendens Plantago spp. Aesculus hippocastanum perfoliatum
Astragalus m. Ceanothus spp. Cnicus Petroselenium
Stillingia spp. Acalypha spp. Hamamelis virginiana benedictus crispus

Zingiber off. Equisetum spp. Vaccinium myrtillus

Myrica spp. Geranium maculatum & Centella asiatica

spp.

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2025 Medicines from the Earth Wound and Infection - Coffman

Granulation Granulation (Exudative)

Epithelialising Maceration

Slough Slough

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 2025 Medicines from the Earth Wound and Infection - Coffman

Necrotic Bio-burden

Charcoal - Wound Case Case Studies

Study Charlie – April 8th, 2018

Ankle – Cellulitis Ankle – Cellulitis

Ankle – Cellulitis
(Nicaragua): (Nicaragua):
(Nicaragua):
2 hours of Charcoal 4 hours of Charcoal,
Before Charcoal
2 hours of herbs

Case Studies First 4 Weeks

Charlie – April 8th, 2018 Honey +
- Plantain
- Chaparral
- Oak
- Arnebia euchroma
Alternating with
Mesalt Gauze

Alternating with
Prickly Pear

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 2025 Medicines from the Earth Wound and Infection - Coffman

Case Studies Case Studies

Charlie – April 8th, 2018 Charlie – April 12th, 2018

Case Studies Case Studies

Charlie – April 20th, 2018 Charlie – July 3rd, 2018

Case Studies Brown Recluse Bite

Charlie – July 3rd, 2018 Echinacea flower and root poultices on
the full area

Day 1 Day 2 Day 4

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 2025 Medicines from the Earth Wound and Infection - Coffman

Diabetic Ulcer – Day 1 Diabetic Ulcer – Day 13

Honey +
- Chaparral
- Black Walnut
- Echinacea

Diabetic Ulcer – Day 33

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 2025 Medicines from the Earth Grief & Loss - Love

MATTERS
of the heart
Herbal Support for Grief & Loss
About Me
W H O I S T E S I A L O V E ?

© 2025 Tesia Love. All rights reserved.

OUR
TIME TODAY
About You •

•
Overview of Grief & Loss
Means of Support
W H O ’ S I N T H E R O O M ?
• Materia Medica
• Recipes & Suggestions
• Q & A

TYPES OF GRIEF
OVERVIEW Normal Grief
of grief & Complicated Grief
loss Acute Grief
Anticipatory Grief
Traumatic Grief
© 2025 Tesia Love. All rights reserved.

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 2025 Medicines from the Earth Grief & Loss - Love

Body systems
EFFECTS OF GRIEF
Heart-Mind Connection

NERVOUS DIGESTIVE MUSCULO-

SKELETAL

© 2025 Tesia Love. All rights reserved.

Body systems Body systems

CARDIOVASCULAR RESPIRATORY ENDOCRINE IMMUNE

© 2025 Tesia Love. All rights reserved. © 2025 Tesia Love. All rights reserved.

STAGES OF GRIEF
Denial AYURVEDIC VIEW
Anger
Bargaining The knowledge of life
Depression
Acceptance

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2025 Medicines from the Earth Grief & Loss - Love

FIRE EARTH

Five Elements
P A N C H A M A H A B H U T A S AIR WATER

ETHER AIR
mobile
subtle cold
cold dry
clear clear
light light
rough

FIRE WATER
hot
moist
sharp
soft
clear
cool
spreading
smooth
flowing

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 2025 Medicines from the Earth Grief & Loss - Love

EARTH
DOSHA
heavy
dull
hard
gross VATA PITTA KAPHA
stable

Support
Vata & Grief
Vata
Feelings of emptiness
Ungrounded Grounding
Anxiety Warmth
Fear Stability
Overwhelm

© 2025 Tesia Love. All rights reserved. © 2025 Tesia Love. All rights reserved.

Support
Pitta & Grief
Pitta
Anger
Rage Cooling
Overdrive Support / Stability
Digestion of the Experience

© 2025 Tesia Love. All rights reserved. © 2025 Tesia Love. All rights reserved.

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 2025 Medicines from the Earth Grief & Loss - Love

Kapha & Move

Grief Kapha
Feeling heavy Lighten
Stuck Brighten
Depression Stimulate
Withdrawal Clear

© 2025 Tesia Love. All rights reserved. © 2025 Tesia Love. All rights reserved.

MEANS of support
Teas
MEANS Tinctures
of support Churnas
Essential Oils
Food
Flowers
Flower Essences

HAWTHORN
(crataegus spp.)
MATERIA
medica TASTE: Sour, Sweet

TEMP.: Heating

ACTIONS: Vasodialator, Antispasmotic, Hypotensive, Diuretic, Carminative,

Stimulant, Antioxidant

FORM: Tincture, Tea, Decoction, Powder/Capsule

© 2025 Tesia Love. All rights reserved.

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 2025 Medicines from the Earth Grief & Loss - Love

MIMOSA (ALBIZIA) ROSE

(albizia julibrissin) (rosa spp.)
TASTE: Bitter, Astringent, Pungent, Sweet
TASTE: Sweet, Bitter
TEMP.: Cooling
TEMP.: Cooling
ACTIONS: Nervine Tonic, Anti-inflammatory, Alterative, Emmenagogue,
ACTIONS: Nervine, Vulnerary, Analgesic Carminative

FORM: Tincture, Capsules FORM: Tea, Tincture, Powder

LINDEN LEMON BALM

(tilia spp.) (melissa officinalis)

TASTE: Sweet TASTE: Pungent, Sweet

TEMP.: Cooling TEMP.: Cooling

ACTIONS: Nervine Tonic, Vasodilator, Hypotensive, Diaphoretic, Anti-spasmotic, ACTIONS: Nervine Tonic, Diaphoretic, Carminative
Anti-inflammatory, Demulcent, Astringent
FOMR: Tea, Tincture, Powder/Capsule
FORM: Tea, Tincture

MOTHERWORT SKULLCAP
(leonurus cardiaca) (scutellaria lateriflora)

TASTE: Bitter, Pungent TASTE: Bitter

TEMP.: Cooling TEMP.: Cooling

ACTIONS: Nervine, Diaphoretic, Diuretic, Alterative, Emmenagogue ACTIONS: Nervine (tonic), Mild Nervine Sedative, Analgesic, Anti-Spasmotic

FORM: Tea, Tincture, Powder/Capsule FORM: Tea, Tincture, Powder/Capsule

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 2025 Medicines from the Earth Grief & Loss - Love

PASSION FLOWER BORAGE

(passiflora incarnata) (borago officinalis)

TASTE: Bitter, TASTE: Astringent, Sweet

TEMP.: Cooling TEMP.: Cooling

ACTIONS: Nervine, Diuretic ACTIONS: Nervine, Diaphoretic, Diuretic, Demulcent, Anti-inflammatory

FORM: Tea, Tincture, Powder/Capsule FORM: Tea, Tincture

BLUE VERVAIN WOOD BETONY

(verbena hastata) (stachys officinalis)

TASTE: Bitter TASTE: Bitter, Pungent, Sweet, Astringent

TEMP.: Cooling TEMP.: Cooling

ACTIONS: Nervine (tonic), Anxiolytic, Hypotensive, Anti-spasmotic, Diaphoretic ACTIONS: Nervine Tonic, Astringent, Carminative, Anti-spasmotic

FORM: Tincture, Tea FORM: Tea, Tincture

CHAMOMILE TULSI (HOLY BASIL)

(matricaria chamomilla) (ocimum tenuiflorum)

TASTE: Bitter, Pungent

TASTE: Pungent
TEMP.: Cooling
TEMP.: Heating
ACTIONS: Nervine Tonic, Carminative, Antispasmotic, Analgesic, Diaphoretic
ACTIONS: Nervine, Diaphoretic, Anti-spasmotic, Antibacterial
FORM: Tea, Tincture, Powder/Capsule
FORM: Tea, Tincture, Powder/Capsule

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 2025 Medicines from the Earth Grief & Loss - Love

LICORICE ROOT ASHWAGANDHA

(glycyrrhiza glabra) (withania somnifera)

TASTE: Sweet, Bitter TASTE: Bitter, Astringent, Sweet

TEMP.: Cooling TEMP.: Heating

ACTIONS: Nervine (tonic), Demulcent, Alterative, Anti-Inflammatory ACTIONS: Nervine Sedative / Toinic, Adaptogen, Rejuvenative, Astringent

FORM: Tea, Tincture, Powder/Capsule FORM: Decoction, Powder/Capsule

BRAHMI GOTU KOLA

(bacopa monnieri) (centella asiatica)

TASTE: Bitter, Astringent, Sweet

TASTE: Bitter, Sweet, Pungent
TEMP.: Cooling
TEMP.: Cooling
ACTIONS: Nervine Tonic, Nervine Sedative, Alterative, Anti-spasmotic, Diuretic,
Astringent, Analgesic ACTIONS: Nervine, Rejuvenative, Alterative, Diuretic

FORM: Powder, Decoction FORM: Tea, Decoction

MATERIA medica MATERIA medica

© 2025 Tesia Love. All rights reserved. © 2025 Tesia Love. All rights reserved.

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 2025 Medicines from the Earth Grief & Loss - Love

ESSENTIAL OIL BLEND

uplifting
RECIPES Diffuse: 3 drops Rosemary EO,
suggestions 2 drops Peppermint EO, 1 drop Lemon EO

1 oz Spray: 3 drops Rosemary EO,

2 drops Peppermint EO, 1 drop Lemon EO,
Distilled water

© 2025 Tesia Love. All rights reserved. © 2025 Tesia Love. All rights reserved.

ESSENTIAL OIL BLEND

soothing
HEART-MIND SOOTHER TEA
1 part Linden Leaf & Flower
Diffuse: 3 drops Rose, 2 drops Tulsi (Holy
1 part Lemon Balm
Basil), 1 drop Jasmine, 1 drop Sandalwood
1 part Tulsi (Holy Basil)
1 oz Spray: 3 drops Rose, 2 drops Tulsi 1/2 part Fennel Seed
(Holy Basi), 1 drop Jasmine, 1 drop
Sandalwood, Distilled water

© 2025 Tesia Love. All rights reserved. © 2025 Tesia Love. All rights reserved.

READY TO BUY PRODUCTS References

© 2025 Tesia Love. All rights reserved.

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Q&A

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 2025 Medicines from the Earth Climate Change - Maier

Medicines of the Earth, May, 2025

Kat Maier, RH (AHG)
Sacred Plant Traditions
info@sacredplanttraditions.com

— When you start to heat up, your

body works to cool itself by
— During a heat wave, every one degree increase in temperature can moving warmer blood away from
increase the risk of dying by 2.5 percent. your internal organs and cooler
blood toward them.
• Higher temperatures can strain the heart and make breathing more
difficult, increasing hospitalization rates for cardiac arrest and
— Capillaries at the surface of the
respiratory diseases like asthma. skin fill with blood, which is why
people often look flushed when
• Making adjustments - Mortality increases 5.04% (95% PI, 3.06–7.06%) they are hot.
during the first heat wave of the summer versus 2.65% (95% PI, 1.14–
4.18%) during later heat waves, compared with non-heat wave days
— .You also start to perspire.As
sweat evaporates, it cools the
• Northern regions actually have higher fatality rates as they are not skin, lowering the temperature
acclimated to heat as easily. Just that we see more heat related deaths of the blood below. That blood
in southern climes. then travels back to your internal
organs to cool them down.

Condition Symptoms First-aid and treatment

— In dry climates, sweat Heat cramps • Painful cramps, • Move to a cool place
evaporation can continue to cool especially in the legs and rest. Do not
the body even at high • Flushed, moist skin continue to
temperatures
participate in the
activity.
— That process becomes less • Remove excess
effective as humidity increases.
clothing and place
cool cloths on skin;
— In very humid conditions, sweat
doesn’t evaporate; instead, it just fan skin.
drips off the skin without • Give electrolytes
cooling it. • Stretch cramped
muscles slowly and
— That’s why dry heat can feel gently.
cooler than humid heat.

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 2025 Medicines from the Earth Climate Change - Maier

Heat stroke • Warm, dry skin • Move to a cool

• high fever, usually place and rest.
over 104° F • Call 911 or your
(or 40° C) local emergency
Heat exhaustion • Muscle cramps • Move to a cool • Rapid heart rate medical service.
• Pale, moist skin place and rest. • Loss of appetite Heat stroke is a
• Usually has a fever • Remove excess • Nausea life-threatening
over 100.4° F (or clothing and place • Vomiting medical emergency
34° C) cool cloths on skin; • Headache and needs to be
• Nausea fan skin. • Fatigue treated by a doctor.
• Give electrolytes • Confusion • Remove excess
• Agitation clothing and
drench skin with
cool water; fan
skin.
• Place ice bags on
the armpits and
groin areas.
• Offer cool fluids if
alert and able to
drink.

— Electrolytes are substances that have a natural positive or

— As soil has been rapidly depleted over negative electrical charge when dissolved in water.
the last century and even more
intensively in the past 30 years, it’s not — Electrolytes are minerals until dissolved in your body’s fluids
a surprise that diseases of every kind or water. We need more minerals than we do trace or ultra-
have accelerated rapidly over the same trace minerals
period:

— Electrolytes also work together to manage fluid balance and

— In the UK, researchers started tracking nerve transmission, and have a multitude of functions
nutrient content of food at the beyond that: they regulate blood pressure, transport other
University of London’s King College. nutrients around the body, help regulate hormone activity,
They found that between 1940 and heal wounds, and support metabolic function.
1991, that fruits and vegetables have
lost on average between 20%-60% of
their mineral content. — Minerals are actually the most potent anti-oxidants as they
are the basic building blocks for our endogenous ant-
oxidants (Glutathione, Super Oxidase Dimustase)
— Dr. Linus Pauling (who won the Nobel
Prize… twice) concluded after years of
studying that: — Minerals were the first anti-oxidants on the earth – algae
You can trace every sickness, every created protection for mitochondria via minerals selenium,
disease, and every ailment to a zinc and copper
mineral deficiency. — https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7973026/
.

— Your cells use electrolytes to — 48 servings : - 1/2 cup salt (Pink or sea salt)- 1 & 3/4 teaspoon Nu-salt
conduct electrical charges, — Sodium (+)
(potassium chloride) - 1/2 teaspoon magnesium glycinate Mix well! Then get
which is how your muscles — Magnesium (+) 32 ounce (4 cups) of water then take a 1/2 teaspoon of your dry mixture and
contract. Those same
electrical charges also help — Potassium (+) add it to the 32 ounces of water and mix until dissolved. If want to add flavor
1/4 cup of juice
with chemical reactions, — Calcium (+)
especially when it comes to — Instructions for Making Electrolyte Powder
hydration and the balance of — Chloride (-)
• Mix the salt, potassium, and magnesium together, and store the mixture in
fluids inside and outside of — Phosphate (-) an airtight jar.
cells. This powder is shelf-stable and should stay fresh based on the expiration
— Bicarbonate (-)
•

— The key principle that dates of the potassium and the magnesium.
electrolytes rely on is that
— Instructions for Making a Basic Electrolyte Drink
certain chemical elements can
naturally hold a positive or a • Mix 1/2 teaspoon of the electrolyte powder with 32 ounces of water.
• You can consume this drink as is, or you can add additional ingredients to
negative electrical charge. make a sports drink or spa water. (If you are not ready to consume your
When those elements are electrolyte drink, store your drink in the refrigerator in an airtight bottle.
dissolved in a liquid, that liquid Your refrigerated drink will stay fresh for 3-5 days.
can then conduct electricity. —

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 2025 Medicines from the Earth Climate Change - Maier

• Acorn squash (1 cup cooked without salt): 896 milligrams

• Artichokes (1 cup hearts cooked): 480 milligrams
• Avocado (1/4 of the whole): 272 milligrams
— Sodium potassium pump is formed on surface of cells – these • Banana (1 medium): 430 milligrams
‘generators’ create electricity to move minerals through the cell – • Beets (1 cup raw): 442 milligrams
transport of CA is dependent on this pump • Broccoli (1 cup chopped and cooked): 457 milligrams
• Baby Brussels sprouts (13 pieces): 315 milligrams
— ATPase pump – creates stomach acid to digest. • Beans (1/2 cup dried—amounts vary based on variety): 1,813 milligrams
— Hypokalemia – low K • Cantaloupe (1 cup cubes): 427 milligrams
• Carrots (1 cup chopped): 410 milligrams
— Intimately involved in muscle work, cardiac issues like afib, HBP • Cherries (1 cup without pits): 342 milligrams
and higher pulse rate • Mushrooms (1 cup whole): 305 milligrams
— Too much NA decreases K • Peas (1 cup raw): 354 milligrams
• Peppers (1 cup chopped): 314 milligrams
— Low magnesium – Mag keeps K in right balance
• Parsley (1 cup chopped): 332 milligrams
— Insulin Resistance inhibits K absorption • Potato (1 medium baked with skin): 930 milligrams
— Too many refined carbs • Quinoa (1 cup cooked): 318 milligrams
• Salmon (6 ounces): 730 milligrams
— High cortisol – stress • Spinach (1 cup cooked): 839 milligrams
— Trauma – adrenaline spikes which decreases K • Sweet potato (1 cup baked ): 664 milligrams
• Tomatoes (1 cup chopped): 430 milligrams
— Surgery
— Diuretics

— Magnesium is needed
for more than 300
• One of its main roles is to act as — Works with the mitochondria to biochemical
a cofactor in the biochemical work with the Krebs cycle for reactions in the body.
reactions continuously creation of ATP It helps to maintain
performed by enzymes. It’s — Magnesium calms nerves, slows
involved in more than 600 rate of nerve impulses and VERY
normal nerve and
reactions in your body, including important for heart physiology muscle function,
• Energy creation — Leg cramps
supports a healthy
• Protein formation immune system,
— Constipation - large intestine as keeps the heartbeat
• Gene maintenance a muscle needs to relax
• Muscle movements — Insomnia
steady, and helps
bones remain strong.
• Nervous system regulation: — Palpitations It also helps adjust
— Chronic back pain blood glucose levels.
• Source — Migraines It aids in the
• Chlorophyll 7- 10 cups of — Insulin resistance makes production of energy
veggies absorption of all minerals
• Nuts seeds
and protein.
difficult
• Not Mag Oxide – not absorbed — ALSO NEED VITAMIN D and
well Calcium for absorption

• The highest levels of magnesium in the whole

body are in the heart, specifically in the left Trace Elements /Minerals
ventricle, which does the most work.
• Magnesium is the gatekeeper for calcium being
In 1912, Nobel Peace Prize recipient, Alexis Carre
allowed into muscle cells to cause contraction.
foreshadowed that we will only be as healthy as our soil.
• Magnesium ushers the calcium out of the cell.
Without magnesium to guard the channel,
Micro minerals – below 100 mgs
calcium floods the cell and leads to
iron, chromium, copper, zinc, iodine, manganese and selenium.
hypercontraction of the muscle cells, which
translates into angina and even heart attack.
•Facilitating a multitude of biochemical reactions
• Strongly convincing data shows low magnesium •Crucial building blocks for hundreds of enzymes
levels were behind atherogenesis. Couple this •Being a requirement for normal growth and development as well as
“wrong turn” of focus with a population that’s neurological functions
been increasing calcium intake without •Makes vitamins – like B12 needs cobalt
•Serving as anti-oxidants
increasing magnesium intake, and you have an •Supporting the blood system
exacerbated problem, according to researchers. •Being necessary for certain hormones
•Being required for normal gonadal development

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 2025 Medicines from the Earth Climate Change - Maier

Everything we’ve made, we’ve made from fossil fuels: energy,

food, medicine, and consumer goods. The world has been
organized to burn.

Minerals that are required in small amounts for human

health are known as trace minerals or trace elements. These
include chromium, copper, fluoride, iodine, iron,
manganese, selenium, and zinc.
As a consequence, the planet is inflamed. Global
temperatures records are being broken…oceans are
Top contenders for addition to the list: rising…This is the epoch of endless fire. Human destruction
is tearing apart the web of life, shredding the network of
•Boron: Important for healthy bone health, brain function, relationships between organisms and places in which are
and immune response. lives are embedded. Inflammation is a biological, social,
•Lithium: Considered a calming mineral and important for economic and ecological pathway, all of which intersect,
mental health. and whose contours were made by the modern world.

Rupa Marya and Raj Patel, Inflamed

— In Gilpin, a Richmond neighborhood, the average life expectancy is 63

• In the 1930s, the federal government created maps of hundreds of
years. Just a short drive over the James River sits Westover Hills, a largely
cities, rating the riskiness of different neighborhoods for real estate
investment by grading them “best,” “still desirable,” “declining” or white, middle-income neighborhood that greets visitors with rows of
“hazardous.”
massive oak trees spreading their leaves over quiet boulevards. Life
• Race played a defining role: Black and immigrant neighborhoods expectancy there is 83 years.
were typically rated “hazardous” and outlined in red, denoting a
— Today, some of these neighborhoods can be up to 16 degrees hotter than
perilous place to lend money. For decades, people in redlined areas
were denied access to federally backed mortgages and other credit, tree-covered parts of the same city.
fueling a cycle of disinvestment
• Richmond’s four hottest ZIP codes all have the city’s highest rates of heat-
• City planners also targeted redlined areas as cheap land for new related emergency-room visits.
industries, highways, warehouses and public housing, built with lots
of heat-absorbing asphalt and little cooling vegetation.

— CRP is a protein produced by

the liver
— When bacteria or other cellular
invaders threaten the body, the
• When the air temperature is hotter than skin temperature, which is typically
liver releases CRP as part of the
about 90 degrees, the body gains more heat than it can release. immune response
— Elevated C- reactive proteins are
• When ambient temperature is high, the human body responds via now considered as importantly
thermoregulation: Blood vessels dilate near the skin to transfer heat from the as blood lipids as a marker for
body’s core to the skin, then sweat transfers heat from the skin by evaporation CV health
• The higher the temperature or the longer the heat wave, the more work — This early response is called
required of the cardiovascular system to maintain normal temperature; an acute phase response. It is
therefore, more intense or longer heat waves are likely to have greater health also referred to
effects. as inflammation or
an inflammatory response.
— The acute phase response also
can occur in chronic conditions,
including some autoimmune
diseases.

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 2025 Medicines from the Earth Climate Change - Maier

— In cell membranes they enhance

cell response (to insulin,
neurotransmitters and other
messengers), and facilitate repair
when cells are damaged.
Remember though that since
they are polyunsaturated it is
important to take them with
anti-oxidants as they are
unstable.
— Some important
considerations
— Best source is cold-water (colder
the better) fish
— Maintenance could be 1500-
3000mg dose of combined EPA-
DHA (standard gel weighing
1,000mg contains 300mgs of
Omega 3)

• The primary issue with PUFAs is that they are highly unstable. All fats
have a temperature with which they oxidize (i.e. become unstable,
go rancid, become toxic).
— Polyphenols- Flavonoids
• For PUFAs that temperature is very low. Unstable fats are prone to
— Flavonoids: Water soluble plant
pigments • The human body
oxidation. cannot produce
— bioflavonoids, so they must be
• Oxidation lead to free radicals. Free radicals lead to cellular damage
supplied in the diet.
in your body that can manifest both internally in the form of
damaged organs/glands and externally in the form of rapidly aging
— Yellow & Orange color (Fall
leaves i.e. Ginkgo)
skin.
— Reduce capillary permeability-
Bruising, edema, venous issues
• In addition, many of these fats can become unstable before they even
enter your body. During processing, many of these "seed" oils are — Inversely associated with
exposed to high heat (imagine trying to extract oil from a grape
coronary disease
seed) which can often make the oils go rancid. — Protect Cholesterol from
oxidative damage
• In addition, these oils may be exposed to high heat during travel — Antihistaminic- Stabilize mast
which can also lead to a damaged and unstable product. This is one cell
of the reasons many of these oils are shipped in dark containers and
are required to be refrigerated.

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 2025 Medicines from the Earth Climate Change - Maier

— Quercetin- Most abundant and

most potent flavonoid in
plants. — High antioxidant activity
— Onions,(esp onion skins) — Increase stabilization of collagen
apples, green tea, violets,
— Maintenance of elastin in
pansies, citrus.
connective tissue, blood vessels
— Quercetin may help relieve hay and muscle.
fever, sinusitis, and asthma
because it can block allergic — Reduction of edema
reactions to pollen and reduce — Supports vision
inflammation in the airways — Found to cross blood brain
and lungs. barrier: ADD. Alzheimer's.
— Quercetin blocks an enzyme
that leads to accumulation of
sorbitol, which has been
linked to nerve, eye, and
kidney damage in those with
diabetes.

— Increases the pumping force of the

heart muscle to boost cardiac
output

— Causes direct dilation of smooth

muscle in coronary vessels thereby
lowering their resistance and
increasing blood flow
— Vitamin C content helps to
strengthen tiny capillaries

— Anthocyanidins and
proanthocyanidins in the herb
help to stabilize collagen

— Good source of rutin and OPC’s

— Pomegranate extract inhibits

androgen-independent prostate

Pomegranate juice protects nitric

cancer growth through a nuclear
factor-κB-dependent mechanism.
Tissue State of Heat
— by MB Rettig, et al. Molecular Cancer
oxide against oxidative destruction
Therapy, 2008 Caused by
and enhances the biological actions of
nitric oxide. by LJ Ignarro, et al. Nitric Nitric oxide helps keep blood vessels
—
Oxide, 2006 elastic and open. This is a mechanism • Lack of fluids and nutrition to cool – fails to counter-
Pomegranate juice inhibits oxidized involved in prevention of ED
— associated with plaque and narrowing balance the natural warming nature of vital energy.
LDL uptake and cholesterol
biosynthesis in macrophages, by B of blood vessels
Fuhrman, et al. Journal of Nutritional Plaque is made by LDL uptake by • Builds up when stagnation or tension blocks the flow of
—
Biochemistry, 2005 macrophages. Inhibiting this uptake vital energy - vital energy is very active and does not sit
Pomegranate juice consumption for 3 inhibits plaque production in the
— blood vessels. still and tends to build up heat when blocked.
years by patients with carotid artery
stenosis reduces common carotid Pomegranate studies for prostate
—
intima-media thickness and LDL cancer are encouraging. Activity on • Over-stimulation (physiological or psychological).
oxidation. by M Aviram, et al. NF-kB signifies potent anti-
Clinical Nutrition, 2004 Response to threat. Adrenaline is heating.
inflammatory activity

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 2025 Medicines from the Earth Climate Change - Maier

— Elder Flower (Sambucus

canadensis)
— Dried flowers – sweet, sour,
Diaphoretics slightly acrid, cool, sedative
and stimulating

— Fresh – stimulating
diaphoretic – brings sweat
Herbs to promote sweating in those with weak
Open the window to let the heat out circulation
— Dried – sedative
diaphoretic, reducing
heat, opening pores and
disperses blood
— Elder opens all the tubes

— Yarrow (Achillea
millefolium)
— Bitter, pungent, acid,
diffusive, astringent,
aromatic Heat clearing herbs
— One of the primal remedies
of Western herbal
traditions
— “Master of the blood” Cooling tonic herbs
— Along with diaphoretic
power makes this the
“master of fever”
— Moves blood to or from
surface to cool or maintain
heat and regulate fluids

— Rosa Family
— Increases the pumping force of the
heart muscle to boost cardiac — Hawthorn lf, flower
output and berry Crataegus
spp (also great for
— Causes direct dilation of smooth capillary fragility due to
muscle in coronary vessels thereby high
lowering their resistance and
increasing blood flow proanthocyanidin)
— Rose hip/flowers Rosa
— Vitamin C content helps to spp
strengthen tiny capillaries — Strawberry Fragaria
— Peach Prunus persica
— Anthocyanidins and
proanthocyanidins in the herb — Sumac berry Rhus
help to stabilize collagen spp
— Lemon Balm Melissa
off.

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 2025 Medicines from the Earth Climate Change - Maier

Self-heal (Prunella
vulgaris)

— Draws out heat and

infection
— Great poultice for hot
/infected wounds
— Indicated specifically for
tonsillitis

— Sweet, mineral/salty,
mucilaginous, cool
&moist
— Great for dry atrophy
— Heat/inflammation of
the eyes

Roses are an amazing

remedy for the heart and
soul. Aside from all the
medicinal qualities, there is
the essence of rose that
transcends to a deeper place
like no other.

Oats (Avena sativa) is

especially useful in dealing
with nervous debility
surrounding grief or loss

Tulsi is an adaptogen that

can easily be grown in our
region, where we can harvest
abundantly

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 2025 Medicines from the Earth Climate Change - Maier

Bitter tonics
Oregon Grape Root
Burdock Root
Dandelion Root
Bitters Motherwort
Blue Vervain
Skullcap
Cooling, downward, relaxing energy
Remember the use of these
plants is to increase digestive
fluids so as to better assimilate
nutrients and help a
dry/atrophic system. These
can be cooling and dry
themselves so either warm and
moisten them with other
botanicals or use small
amounts for shorter time.

Refrigerants

Summer heat - heat disorder of the summer season

from exposure to too much heat and humidity.

— Treatment Principle – Clear summer heat, restore

fluids. — 1. Dry skin, hair, eyes
— 2. Bloating (dry digestive juices)
— In addition to clearing heat, these herbs also produce — 3. Gas
fluids and relieve thirst.
— 4. Constipation/hard stool
— 5. Insomnia – caused by heat rising at night
— Watermelon — 6. Joint stiffness
— Cucumber
— 7. Anxiety
— Summer squash
— 8. Excess heat possibly at first because there are no
— Mung bean
— Hibiscus flower coolants to help dampen the temperature but then after
— Lemon Balm awhile without nutrition there can be cold because there
is no vital energy
— Sumac berry

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 2025 Medicines from the Earth Climate Change - Maier

— Demulcents

— Oftentimes the heat that — Marshmallow (Althea

arises is secondary to a off )
dry/atrophic state where
there is a lack of fluids to — Slippery Elm (Ulmus
lubricate/calm the fulva)
tissue. This is what is — Plantain (Plantago spp)
referred to as yin
deficiency. — Violet (Viola spp.)
— Marshmallow Althea — Mullein (Verbascum
off. thapsus)
— Linden Tilia spp
— Shatavari Asparagus
racemosas — Since these are mostly
— Licorice Glycyrrhriza water-soluble nutrients,
glabra
teas are the preferred
method of preparation

— Hydration can be with water or oil

— Water needs to be soft as it is more easily assimilated

than hard water

— Since water follows salt, it is also important to have a

proper amount of good quality salt in the diet as salt
pulls water into tissues that are dried

— In this manner salt is an emollient

— Good oils are

therapeutic for dryness
as well as atrophy
— This is a category that has been brought to us by
— Essential Fatty Acid Traditional Chinese Medicine. At the same time many
North American traditional remedies are included
— Evening Primrose
— Black Cumin
here. When you sit and really taste the flavor of an
— Borage herb, you will often taste a sweetness that might have
— Black Currant been underneath the immediate bitter or sour flavor.
All sweet herbs are nutritive and building.
— Vegetable oils

— Sesame
— Olive
— Sunflower seeds

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 2025 Medicines from the Earth Climate Change - Maier

— American Ginseng (Panax quinquefolium)

— Siberian Ginseng (Eleutherococcus senticosus)
— Codonopsis (Codonopsis pilosula)
— Rehmannia Root (Rehmannia glutinosa)
— Slippery Elm (Umla fulva)
— Astragalus (Astragalus membranaceus)
— Licorice (Glycyrrhiza glabra)

— Ganoderma
lucidum/applanatum
— Highly nutritious
— Polysaccharide

— 2 Bilberries Vaccinium myrtillus

• Eat vegetables, especially those high in water content, like cucumber, — 2 Elderberries Sambucus nigra
cabbage, and lettuces. — 2 qt. Water
• Eat lighter meals. — ½ c Honey
• Eat liquid-based meals, like soups and stews. — ½ c Blueberry concentrate Vaccinium corymbosum
• Eat fruit, especially melons. — 1c Brandy (optional)
• Try adzuki or mung beans, which are refrigerants. —
— This formula is meant to be made into a syrup. Begin by either measuring out 1
• Black beans, kidney beans cup of each of the berries or weigh 2 ounces each. Into sauce pot add the herbs
• Reduce your use of ice, which can dilute digestion. and water. Bring to a boil then simmer until the water is reduced by half.
Strain through a tightly woven sieve so that you can mash the berries extracting
• Focus on foods that are sweet, astringent, and bitter. the pulp with out skins or seeds, discard the herbs.
— Mix in the honey while it is still warm. Add the blueberry concentrate, you may
want more or none at all. The brandy is optional, for longer shelf life of the
formula it is helpful unless you can refrigerate and consume the syrup in two
weeks.
—

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 2025 Medicines from the Earth Climate Change - Maier

— Green space can be

transformative.

— Trees cool down — With Herbalista.org as our

mentor, we have set up
neighborhoods by several degrees medicinal herb and gardening
during a heat wave. classes at local community
gardens.

— When planted near roads, trees — This is a direct way herbalists

can engage with their
can help filter air pollution. communities to introduce food
and medicine plants but more
IMPORTANTLY, it provides a
— The presence of green space can forum to learn from
communities we work with.
even reduce stress for people
living nearby.

https://bit.ly/mutual-aid-herbs
www.yourherbalpractice.com

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 2025 Medicines from the Earth Surface Eruptions - Proefrock

Surface
Primary Lesions
arise de novo and are most characteristic of the disease process
Eruptions:
An Herbalist’s • Bulla: a circumscribed, elevated fluid-filled lesion greater than 1 cm in size (e.g.
epidermolysis bullosa, bullous impetigo). A large blister.
Primer on Skin
Rashes and • Macule: a circumscribed, flat lesion with color change up to 1 cm in size that is
Their Treatment not palpable (e.g. freckles, ash leaf macules, café au lait macules).
• Nodule: a circumscribed, elevated solid lesion with depth up to 2 cm e.g. cyst.
Dr. Kenneth Proefrock • Papule: a circumscribed, elevated solid lesion up to 1 cm in size, elevation may
be accentuated with oblique lighting, e.g. Mila, acne, verrucae.
• Plaque: a circumscribed, elevated, plateau-like, solid lesion greater than 1 cm in
size (e.g. psoriasis).
• Pustule: a circumscribed, elevated lesion filled with purulent fluid, less than 1
cm in size (e.g. erythema toxicum neonatorum, acne).
• Vesicle: a circumscribed, elevated, fluid-filled lesion up to 1 cm in size (e.g.
herpes simplex).

Bullae Macule
• Circumscribed fluid-filled lesions that are greater than 1 cm. in diameter. A flat, change in the color of the skin, macules greater than 1 cm. are referred to as patches.

8-year-old boy with a macular

Diabetic foot bullae in 64 year old rash associated with the viral
female 4-year-old boy with bullae on the disease erythema infectiosum,
2-year-old female with Stevens- pinna of his ear from a contact
Johnson syndrome has both fifth disease.
dermatitis. 18 month old with 3-year-old girl with tuberous
bullae and vesicles. neurofibromatosis and sclerosis has hypopigmented
characteristic cafe-au-lait macules and patches.
macules.

Nodule Papule
Raised solid lesion more than 1 cm, may be in the epidermis, dermis, or subcutaneous tissue. Solid raised lesions with distinct borders and less than 1 cm in diameter, occurring in a variety of shapes (domed,
flat-topped, umbilicated) and often with secondary features such as crusts or scales.

Tinea corporis is a fungal

papulosquamous lesion.
Basal cell carcinoma on the scalp of a Axillary lymph nodule of a 6-year-old boy 5-year-old boy with hundreds
23-year-old male associated with cat-scratch fever-Bartonella of papules with a generalized Molluscum contagiosum in a 3-year-old girl.
henselae hypersensitivity reaction to a
fungal infection.

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Plaque Pustule
Circumscribed elevated lesions that contain pus, most commonly an infection (folliculitis) but may be
Solid, raised, flat-topped (think plateau) lesion greater than 1 cm in diameter sterile (pustular psoriasis).

Pustular psoriasis

Acne
Shagreen plaque associated with tuberous Psoriatic plaque on the upper thigh of vulgaris
sclerosis on the left lumbosacral area of a 7- a 42-year-old female. Psoriatic plaque below the pustules
year-old knee on an 18-year-old male
Pustules on the foot of a 15-
year-old boy caused by a
group A beta-hemolytic
Streptococcal infection Ruptured pustule on the foot
of a 6-week-old infant

Acne Vulgaris
vesicle A very common skin condition involving blockage and/or inflammation of the hair follicles and their
Raised lesions less than 1 cm. in diameter that are filled with clear fluid accompanying sebaceous gland, presents with noninflammatory lesions, inflammatory lesions, or a
mixture of both, affecting mostly the face but also the back and chest.
Acne is associated with four factors:
3-year-old with oval vesicles
in his palm from Coxsackie (1) follicular epidermal hyperproliferation (more skin tissue growth) with subsequent plugging
virus.
of the follicle
(2) excess sebum production
(3) the presence and activity of the commensal bacteria Cutibacterium acnes (formerly
Propionibacterium acnes)
Herpangina in a 9 year old
(4) inflammation .
with Coxsackie virus

Vesicular eruption typical of

Genetics is also a key factor in the pathophysiology of acne.
shingles, Varicella zoster

Acne is exacerbated by increasing levels of Dihydrotestosterone (DHT) acting on genetically

susceptible androgen receptors in the follicle.

DHT or 5α-dihydrotestosterone (5α-DHT), also known as androstanolone (5α-androstan-17β-ol-

3-one) as well as 17β-hydroxy-5α-androstan-3-one, is a sex steroid and androgen hormone
converted from testosterone via the 5α-reductase enzyme in the prostate, testes, hair follicles,
and adrenal glands.
This enzyme reduces the 4,5 double-bond of testosterone, producing DHT, which is 5 times
more androgenic.

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The following medications are used in the treatment of acne vulgaris: Benzoyl Peroxide
Topical anti-microbials: erythromycin, benzoyl peroxide, clindamycin,
Benzoyl peroxide possesses both comedolytic and antimicrobial properties
azelaic acid, based on the rationale that killing the bacteria stops the
Available in various formulations and concentrations ranging from 2.5% to
inflammatory cycle.
10%
When a topical or systemic antibiotic is used, it should be used in Typically, applied once daily, focusing on 1 or 2 small areas during the initial
conjunction with benzoyl peroxide to reduce the emergence of resistance. 3 days to test for any potential hypersensitivity reactions.
Retinoids: topical tretinoin, adapalene, tazarotene, isotretinoin, Benzoyl peroxide should not be applied simultaneously with tretinoin due to
hydroxypinacolone, which act on the follicle to reduce sebum production its oxidizing effect on tretinoin. To avoid any reaction, benzoyl peroxide
should be applied in the morning, whereas tretinoin should be applied in the
Systemic Antibiotics: tetracycline, minocycline, doxycycline, sarecycline,
evening.
trimethoprim/sulfamethoxazole, clindamycin, daptomycin, based on the
premise that the whole ecology is compromised and manifesting in the skin. It is important to note that skin irritation may occur with benzoyl peroxide
use, particularly at high concentrations. It may also have a bleaching effect on
Selective aldosterone antagonists (spironolactone) clothing and hair.
Androgen receptor inhibitors (clascoterone) Salicylic acid is a desquamating keratolytic (it promotes the sloughing of old,
dead and dying skin cells), it is also comedolytic and antimicrobial and
Estrogen/progestin combination oral contraceptive pills—to establish a
available over the counter at concentrations of 1-5%.
stable hormonal base, reducing androgen production.

New law pertaining to the harvest, sale and purchase of

Serenoa repens-Saw Palmetto
Saw palmetto is used in several forms
of traditional herbal medicine. Native
people from the Americas have used
the fruit for food and as a treatment SAW PALMETTO BERRIES
for urinary and reproductive issues for Section 581.189, Florida Statutes
Effective July 1, 2024, there will be new requirements for both harvesters and those who buy, transport and
millennia. process saw palmetto berries in Florida and new penalties for those who do not comply with the new law.

The Mayans drank it as a tonic and Harvesters:

the Seminoles used the berries as an • Saw palmetto berries may only be harvested from private property with prior written landowner
permission and those harvesting must first have:
expectorant and antiseptic. o Written permission from the landowner, and
o A permit from FDACS as provided in s. 581.185, Florida Statues.
Inhibits conversion of testosterone to o Written landowner permission must include:
DHT, decreasing severity of acne and ▪ Name, address, telephone number of landowner
hair loss. ▪ Start date, end date, and location, including county, of the harvest
▪ The landowner’s actual or electronic signature
May also increase conversion of • Unauthorized harvest of saw palmetto berries from state public lands is not allowed. That means it is
illegal to harvest from Florida state forests, state park lands, wildlife management areas, water
Testosterone to Estrogen management district lands, or any other category of public land unless authorized by the agency that
administers the land. The unauthorized harvest of saw palmetto berries on public lands will be a third-
Dosage is typically 320 mg/day
degree felony beginning July 1, 2024.
Buyers, transporters and processors
• Are NOT REQUIRED to have a permit
• However, when you purchase saw palmetto berries from a harvester, you must maintain the following
items and retain them for a period of two years from the date the harvest ends:
o A bill of lading for the berries
o A copy of the harvester’s entire permit
o A scan or photocopy of the harvester’s valid government photo I.D.
o A copy of the landowner’s written permission to harvest, including:
▪ Seller’s name, address and telephone number
▪ Date or dates of harvesting
▪ Weight, quantity, or volume and description of the type of saw palmetto berries
harvested

Florida Department of Agriculture and Consumer Services

Office of Agricultural Law Enforcement Wilton Simpson, Commissioner

Cucurbita pepo—Pumpkin seed Prunus africana--“Pygeum” or “African cherry”

Evergreen tree from forests scattered across sub-
Native to the Americas, pumpkin seeds have been used in folk medicine Saharan Africa, Madagascar, and surrounding
worldwide for the treatment of gastrointestinal diseases and intestinal islands. Traditionally, decoctions of the stem-bark are
parasites, as well as hair and skin care for the past five centuries. They taken orally for the treatment of a wide variety of
contain secondary metabolites such as terpenoids, quinones, saponins, conditions, such as benign prostatic hyperplasia
steroids, phenols, tannins, alkaloids (berberine), cucurbitine, and (BPH), stomach-ache, chest pain, malaria, heart
palmatine. conditions, and gonorrhea, as well as urinary and
They inhibit 5 alpha reductase activity, have anti-androgenic activity, kidney diseases. The timber is used to make axe
and generally anti-inflammatory. Topical use of the oil is reportedly handles and for other household needs. The dense
stimulating to the circulation and conditioning to the hair follicle. wood is also sawn for timber.
Significant increases in harvesting over the past few
The oil can be consumed and used topically, the seeds are food, eat
decades has caused this tree to be added to the
them freely and often and with wild abandon. Appendix II of the Convention Trade in Endangered
species. Attempts at sustainable cultivation and
harvesting are taking place in Cameroon.

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Beta-sitosterol
Phytosterols are sterols, a biochemical category that contains Urtica dioica/urens-Nettles
over 200 identified members, they are structurally similar to
cholesterol. Nettle is one of the most widely applicable plants in western
Phytosterols occur naturally in free form as well as bound herbalism, it is astringent and very useful for myofascial pain
forms such as esters of glycosides or fatty acids. Free conditions, and its root possesses some 5 alpha-reductase inhibiting
phytosterols are soluble in alcohol and insoluble in water. effects. It may best be done as a nourishing herbal infusion, 1 oz of
The daily intake of phytosterols is typically between 150 mg
and 450 mg per day, depending on diet. Some vegetarian diets
dried herb added to a quart of hot water and allowed to steep for 8-
provide up to 700 mg of phytosterols per day. 10 hours (overnight) the preparation is pressed through a French
press the next morning and then the infusion drank throughout the
Beta-sitosterol is one of the most abundant naturally occurring day, it is nice with a bit of lemon or lime added to it and/or some sea
phytosterols, and it typically accounts for about 65 percent of salt or smoked sea salt. Tincture dosage is ½-1 tsp 3 times daily. It is
the dietary intake of phytosterols in humans. Campesterol
accounts for about 30 percent of phytosterol intake and
rich in mineral constituents, and helps build and repair connective
stigmasterol comprises the majority of the remainder. Beta- Reportedly has 5 alpha reductase inhibition tissue and fascia, and reduces hair loss, prostatic swelling and severe
effects and blocks DHT binding at receptor
sitosterol is also the primary phytosterol used in health acne associated with DHT production.
supplements.

Seborrheic dermatitis
Also called seborrheic eczema, is a chronic skin condition that
predominantly affects the scalp, damages the hair follicles and hinders
hair growth. Seborrheic dermatitis can be a fungal disease, it can also be
due to a developed intolerance to one’s own secretions.
Pygeum africanum
“Seborrhea” characterizes chronic inflammatory conditions that cause
scaly skin and oily skin due to excessive sebum production by the
sebaceous glands.

Increased sebum production creates irritation and inflammation on the

scalp with intense itchiness. Scratching the scalp damages hair follicles,
which obstructs natural hair growth, causing hair to fall out.

Excess sebum production can also increase the amount of the naturally-
occurring yeast, Malassezia on the skin, causing inflammation and
further damage to hair follicles.

Vitamin A encourages the growth of new skin cells whilst breaking down dead
Vitamin A skin cells. It can also regulate the amount of keratin being produced by your
skin and prevent dead skin cells from sticking together and forming acne-
causing blockages in hair follicles.
In addition, vitamin A can regulate skin tone and reduce the red, purple and
brown colouring that acne can leave on the skin. It can also reduce the size and
productivity of your oil glands, meaning that your skin produces less acne-
causing oil.
Vitamin A can make your skin more sensitive to the sun, meaning that a non-
oily sunscreen should be used whilst treatment is ongoing. Further side effects
of vitamin A include skin irritation, dryness and peeling, vomiting, diarrhoea,
liver complications and hair loss
As with most acne treatments, vitamin A takes time to work and you should
allow for twelve weeks of use before determining whether or not the product
has worked for you. It is also advised that you continue to use vitamin A (if it
has proven effective) even after your acne symptoms have improved. The skin
sheds its top layer every twenty-eight days and acne problems may reoccur if
the treatment has been stopped

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Hydrogel
Vitamin A lemon drop hydrogel A hydrogel is a three-dimensional network of hydrophilic polymer chains that have the capacity to absorb and retain
a significant amount of water within their structure…often exceeding 90% of their total weight.
• 1 % Allantoin This water content allows them to mimic natural tissues and adds to their biocompatibility, they do not elicit adverse
immune responses when in contact with living organisms.
• 3% Pentoxifylline
Depending on their composition and cross-linking density, hydrogels can have varying degrees of softness and
• 0.025% Vitamin A (as tretinoin)
flexibility, and they typically possess a porous structure that allows for the diffusion of substances such as nutrients
• 10 drops of lemon essential oil and drugs. This property is crucial in drug delivery systems and tissue engineering.
Hydrogel dressings provide a moist environment for wound healing and are used for burns, ulcers, and surgical
• In aloe/hyaluronic acid 10 mg/ml gel and applied to skin lesion wounds as well as moisturizers, face masks, and eye patches for their ability to provide intense hydration and
1-2 times a day cooling effects.

Boswellia serrata-Frankincense
Skin remodeling-scar tissue
Boswellia serrata (Salai/Salai guggul), is a moderate to large sized branching tree
of family Burseraceae (Genus Boswellia), grows in dry mountainous regions of
Acne vulgaris is generally a temporary condition, the scarring the results India, Northern Africa and Middle East.
can last a lifetime—initiating healthy remodeling, limiting fibroblast activity The resin of Boswellia species has been used as incense in religious and cultural
can be very helpful. ceremonies and in medicines since time immemorial.
Oleo gum-resin is tapped from the incision made on the trunk of the tree and is
then stored in specially made bamboo basket for removal of oil content and
getting the resin solidified.
Tendskin—15% Acetylsalicylic acid in Isopropyl alcohol—glycerin—especially The oleo gum-resins contain 30-60% resin, 5-10% essential oils, which are soluble
beneficial for people who tend to cheloid formation- in organic solvents, and the rest is made up of polysaccharides.
Gum-resin extracts of Boswellia serrata have been traditionally used in folk
Hamamelis--Witch hazel--astringent medicine for centuries to treat various chronic inflammatory diseases.
Miederma—onion skins, extractum cepae The resinous part of Boswellia serrata possesses monoterpenes, diterpenes,
Vitamin A/Vitamin E/Vitamin D—promote better skin remodeling triterpenes, tetracyclic triterpenic acids and four major pentacyclic triterpenic
acids responsible for inhibition of pro-inflammatory enzymes.
Hydrogels—for acne for scarring— Acetyl-11-keto-β-boswellic acid appears to be the most potent inhibitor of 5-
lipoxygenase enzymes and topical application reduces the formation of scar
Boswellia-an inhibitor of scar tissue formation tissue.

Impetigo cellulitis
Cellulitis is an acute bacterial infection causing inflammation of the
deep dermis and surrounding subcutaneous tissue, it presents as a
poorly demarcated, warm, erythematous area with associated edema
and tenderness to palpation.
The infection is without an abscess or purulent discharge and is
Impetigo is a common skin infection in children between the ages of 2 and 5 years old. It is usually caused by group A streptococcus (Strep pyogenes), and Beta-
highly infectious and is caused primarily by gram-positive bacteria, mainly Staphylococcus hemolytic streptococci followed by methicillin-sensitive
aureus and group A beta-hemolytic streptococcus. The lesions are characteristic, appearing as Staphylococcus aureus.
bullae that dry to form a honey-colored, thick crust that may cause pruritus. Most impetigo
infections resolve without requiring antibiotics; however, to reduce the duration and spread of Patients who are immunocompromised, colonized with methicillin-
the disease, topical antibiotics are used. Oral antibiotics are generally reserved for patients with resistant Staphylococcus aureus, bitten by animals, or have
more severe or treatment-refractory infection and include penicillinase-resistant penicillin or comorbidities such as diabetes mellitus may get secondary infections.
first-generation cephalosporins. Over 14 million cases occur in the United States annually accounting
for approximately 3.7 billion dollars in ambulatory care costs and
650,000 hospitalizations

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Echinacea purpurea/angustifolium Rudbeckia laciniata

Classically used for increasing the resistance of the body to infection and used in boils, Yellow Cone Flower/Dormilon
septicemia, cancer, and other infective conditions. Traditionally used to treat a wide variety of infectious states, often regarded as a replacement
for Echinacea…similar but not the same.
Echinacea preparations are commonly used as nonspecific immunomodulatory agents. Regional Native American uses included the treatment of colds and helminthic invasions;
Alcohol extracts from three widely used Echinacea species, Echinacea angustifolia, rinses were used topically to treat wounds, ulcerative skin lesions and snake bites; root juice
Echinacea pallida, and Echinacea purpurea, have been studied for immunomodulating used for the treatment of earache, edema and dropsy
properties. The three species demonstrate a broad difference in concentrations of
individual lipophilic amides and hydrophilic caffeic acid derivatives, and all three Arabinogalactan lectins possess immunomodulatory properties, phytohemagglutinin, T-cell
extracts induce similar, but differential, changes in the percentage of immune cell mitogen and B-cell mitogen activity, leucocyte blast transformation, and IgM antibody
populations and their biological functions. Echinacea is a wide-spectrum production. Arabinogalactan enhances the secretion of granulocyte-macrophage colony-
immunomodulator that modulates both innate and adaptive immune responses. E. stimulating factor, tumor necrosis factor-α, interleukin-6 and interferon-γ, and also activates
the complement system in the classical and alternative pathways.
angustifolia and E. pallida may have more anti-inflammatory potential.
Classically, water decoctions seem more clinically useful…and conducive to hydrogel Whole plant extract increases interferon production
formation. Tiarubrin C, isolated from the roots, exhibits pronounced antibacterial and antifungal
properties and can be used as an antiseptic.
The plants, their extracts, and chemicals isolated from them exhibit an immunomodulatory,
anti-inflammatory, and antioxidant effect.

Baptisia tinctoria
Wild Indigo Berberis fremontii/
Tincture of dried root 1:5, dosed at 5-10 drops 3-4 Mahonia/B. trifoliata/
times a day, increase dosage as tolerated-too much too Berberine containing plants, similarity in action but not the same…
fast will create gastrointestinal distress.
Generally, a bitter tonic for digestion, a stimulant for liver metabolism,
Some specific indications: antimicrobial for intestinal tract and helpful in skin rashes and wounds.
Inflamed gums from general immunosuppression. Cold and astringent…long considered to be a helpful lymphagogue and anti-
Purulent laryngitis with systemic effects. microbial agent in botanical medicine.
Studies have shown a 4% w/w ointment demonstrated considerable wound
Chronic sinusitis with necrotic, foul discharge.
contraction, epithelization time, and improved wound index.
Chronic tonsillitis with necrosis. Broadly antibacterial, antiviral, and antifungal, root extracts exhibit moderate
Cellulitis/Impetigo cytotoxicity and changes in the signaling pathways linked to immune cell adhesion,
Septic diarrhea. proliferation, and migration.
Dried root tincture 1:5, dosed at 10-60 drops 3-4 times per day
Highly effective ultradilute medicine for the
treatment of typhoid; activates both T and B cells Makes a great hydrogel mixed in 10 mg/ml Hyaluronic acid after ETOH removal.
and the formation of antibodies.

Tinea pedis (Athlete’s Feet) Topical Anti-fungals

ringworm/Tinea corporis Topical imidazoles such as clotrimazole, econazole, ketoconazole, miconazole,
isoconazole, tioconazole, and sulconazole offer effective remedies with a very
Tinea pedis, commonly known as athlete's foot, results from fungal infections on the skin of the feet caused by
low incidence of adverse effects. They interfere with the cytochrome P450
dermatophytes, including Trichophyton rubrum, T mentagrophytes, T interdigitale, and Epidermophyton floccosum. This
system of both humans and the fungus, some people experience an increase in
infection typically occurs through direct contact with the organism while walking barefoot in locker rooms,
their liver enzymes as a result, even topical application can do this.
showers, and swimming complexes. Individuals with diabetes and those who wear occlusive shoes are at an
increased risk.
Topical application of terbinafine and amorolfine yields faster results in
treating Tinea pedis than clotrimazole treatment, adding a topical keratolytic,
like a 3-5% salicylic acid, can be beneficial in patients with hyperkeratosis.
Using prophylactic tolnaftate powder after swimming and showering in
community settings reduces the levels of toe cleft tinea pedis caused by T.
interdigitale. Generally, topical treatment lasts for 4 weeks, although some
patients may experience symptom resolution sooner. Terbinafine 1% can
provide effective results for interdigital tinea pedis after 1 week. Repeated KOH
scrapings and cultures should yield negative results.

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Baking soda-sodium bicarbonate Encelia Farinosa-brittle brush

Baking soda is notably anti-fungal, and it controls
A member of the Asteraceae family, a perennial shrub with a native distribution
odors. Adding it to one’s shoes is a rapid way to
that grows throughout the Sonoran desert from northern Mexico to Arizona
resolve both foot fungus and foot odor. The including the Mojave Desert and the coastal chaparral of southern California, the
baking soda tends to have a drawing effect, interior valleys of southern California, and southwestern Utah. This shrub is very
increasing the amount of sweat from the feet, it is drought tolerant and important for revegetation and erosion control and habitat
imperative to keep the feet as dry as possible—a restoration.
second or third pair of shoes to change into with It reproduces asexually by being easily broken and portions of branches get
fresh socks through the day. Baking soda is not deposited elsewhere and root. The broken ends secrete a yellow resin that dries and
kind to all of the materials that shoes are made can be easily collected. A standard beeswax and olive oil salve with 10% Encelia
from and can seep through the fabric as a white resin added to it is amazingly antifungal and smells wonderful—you too could
crust, no one loves that but it may be a small garner the nickname honeyfoot.
price to pay. Depending on the presentation of the fungal infection, a beeswax and olive oil
preparation may not suit your needs, it tends to be heating.

Molluscum contagiosum
Warts-verruca vulgaris Also called water warts, a benign condition of the skin caused by a double-stranded DNA poxvirus called molluscum
contagiosum virus (MCV). Four subtypes of the molluscum contagiosum virus are known; MCV-1 (98% of cases) is
Sometimes the practitioner can “purchase” the warts of their younger patients, giving them a dollar for mostly seen in children, while MCV-2 is mainly responsible for skin lesions in people living with HIV. MCV-3 and
each wart usually makes the wart disappear in 1-2 weeks. Psychotherapy, homeopathy and constitutional MCV-4 are present in Asia and Australia. The skin lesions are called Mollusca and appear as dome-shaped, round,
botanical prescribing: including a lengthy interview is usually successful in adult patients. and pinkish-purple in color. In 2010, there were about 122 million cases, although it occurs worldwide, it is more
frequent in warm, humid regions. Molluscum contagiosum is diagnosed mainly in children aged two to five years, but
Topical interventions like 25% Podophyllum in alcohol, Thuja oil, salicylic acid, liquid nitrogen and also in sexually active teenagers and adults, and immunocompromised persons
surgical removal can be construed as superficial and suppressive, some level of internal treatment with
Molluscum contagiosum lesions are transmitted by direct skin-to-skin or indirect (towels, underclothes, toys, razor,
agents that enhance host anti-viral defenses may be more ideal, consider botanical 'anti-viral' agents like
tattoo supplies) contact. Molluscum contagiosum may also disseminate by autoinoculation to normal skin after
Lomatium, Hypericum, Glycyrrhiza, vitamin A and Melissa. mollusca scraping by the patients. Transmission from sharing swimming pools and other wet environments is possible
This concept of an herbal antiviral can get complicated-these are not necessarily items that kill viruses in a but not fully proven. In utero and prepartum transmissions are occasionally reported, resulting in congenital
petri-dish--nor in the far more complicated living organism. The plant and its constituents stimulate a wide molluscum contagiosum or skin lesions developing during the early months of life.
range of host defenses that include some responses to viral organisms that might lead to their eradication, Topical application of a 0.25% tretinoin hydrogel (10 mg/ml hyaluronic acid) is usually very effective.
or their assimilation into the micro-ecology of the body, as the case may be.

The Six Exanthemas of Childhood

Podophyllum peltatum-Mayapple
Podophyllotoxin is the basis for two chemotherapy drugs (etoposide and An “exanthem” is a widespread rash and there were 6 distinct
teniposide) both microtubule inhibitors, binding to tubulin and exanthemas of childhood that were numerically designated 1-6
preventing formation of microtubules resulting in mitotic arrest in 1905. Today we only really refer to Fifth Disease, and
Podophyllum resin is a mixture of resins derived from the mandrake sometimes Sixth, by this older categorization. The six original
plant, primarily used as an antimitotic agent for treating genital or exanthemas were:
perianal warts.
Exercises many biologic effects such as damages endothelium of small First disease: Measles/Rubeola
blood vessels, attenuates nucleoside transport, suppresses immune Second disease: Scarlet Fever
responses, inhibits macrophage metabolism, induces interleukin-1 and Third disease: Rubella (AKA German Measles)
interleukin-2, decreases lymphocyte response to mitogens, and enhances Fourth disease: Dukes’ Disease
macrophage growth.
Fifth disease: Parvovirus B19
Apply 0.5% solution or gel q12h in the morning and evening for 3 days, Sixth disease: Roseola Infantum
then withhold for 4 days. Repeat cycle up to 4 times.

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First Disease: Rubeola/Measles Measles/Rubeola

Historically considered the greatest killer of children, still responsible for more than 1 million deaths worldwide (mostly in
developing countries where the death rate can be as high as 10%--while the child fatality rate in industrialized nations is only 0.1%- Maculo-popular rash
0.2%.
and Koplik’s spots
It is highly transmissible, with an infectivity rate of 76%, it is contagious from just before the prodromal symptoms until four days
after the onset of the rash.
Classic symptoms include cough, coryza, and conjunctivitis, photophobia and fever. Patients may have Koplik spots in the mouth
that present in the beginning of infection and resolve as the rash erupts. Infection leads to a prolonged immunosuppression, which
accounts for the morbidity and mortality—often from secondary infections with pneuomonias at the top of the list.

The rash begins on the fourth or fifth day of symptoms and usually begins on the face and behind the ears before spreading to the
trunk and extremities.
Summary of Symptoms:
Days 0-1: Prodrome begins
Days 2-3 Koplik spots appear
Day 4-5: Morbilliform rash begins
Days 6: Koplik spots regress
Days 7-8: Rash is most intense
Day 10: Rash begins to resolve

Treatment is generally supportive with attention to hydration, and quarantine until no

Second Disease-Scarlet fever
longer infectious. The WHO also recommends supplementation with Vitamin A because Associated with group A streptococcus infection, usually tonsillitis. It is not caused by a virus, it is caused by an
these levels drop during the infection, and in developing countries these levels may exotoxin produced by the streptococcus pyogenes (group A strep) bacteria. It is characterized by a red-pink, blotchy,
already be very low, which predisposes one to secondary infections. macular rash with rough “sandpaper” skin that starts on the trunk and spreads outwards, it has a 24-96 hour
incubation period, and the illness tends to start with an abrupt fever, sore throat, vomiting, abdominal pain and
The most common serious and sometimes fatal complications from measles usually myalgia. Rash usually appears 12-48 hours after fever, often starting with red, flushed cheeks and a strawberry
occur in developing countries, and include: dehydration from diarrhea, pneumonia, tongue with cervical lymphadenopathy.
vitamin A deficiency (leading to corneal ulceration and blindness) and
immunosuppression. Treatment is often with antibiotics for the underlying streptococcal bacterial infection. Historically, with phenoxy-
methyl-penicillin (penicillin V) for 10 days. Scarlet fever is a notifiable disease and all cases need to be reported
to public health. Children should be kept out of school until 24 hrs after starting antibacterial.
Suspected cases of measles are reportable to the public health department, and a blood
Patients can have other conditions associated with group A strep infection:
sample from the patient should be obtained for confirmatory testing. •Post-streptococcal glomerulonephritis (occurs in 10-15% of children)
•Acute rheumatic fever

By the time children are 10, about 80% have developed lifelong antibodies against streptococcal exotoxins. The
resolving rash may cause peeling of the skin on the hands, feet, axillae and groin.

Third Disease-Rubella

Rubella is caused by the rubella virus. It is highly contagious and spread by respiratory droplets.
Symptoms start 2 weeks after exposure-nearly half of the infections are asymptomatic.

It presents with a milder erythematous macular rash compared with measles. The rash starts on the face
and spreads to the rest of the body. The rash classically lasts 3 days. It can be associated with a mild
fever, joint pain and a sore throat. Patients often have enlarged lymph nodes (lymphadenopathy) behind
the ears and at the back of the neck. Patients may also complain of pain on lateral and upward eye
movement.

Management is supportive and the condition is self limiting. Rubella is a notifiable disease and all cases
need to be reported to public health. Children should stay off school for at least 5 days after the rash
appears. Children should avoid pregnant women as this is a viral infection that primarily causes
morbidity and mortality (to the fetus) through teratogenic effects when pregnant women contract the
disease (especially in first trimester).

Complications are rare but include thrombocytopenia and encephalitis. Rubella is dangerous in
pregnancy and can lead to congenital rubella syndrome, which is a triad of deafness, blindness and
congenital heart disease.

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Fourth Disease: Sometimes called Dukes Disease.

No specific cause has ever been identified. Many believe Dukes disease
was actually a nonspecific viral rash, others believe fourth disease was
actually an infection related to endotoxin-producing Staphylococcus
aureus, causing Staphylococcal scalded skin syndrome—SSSS.

It has very interestingly been mostly forgotten and is never used in

clinical practice. Even when it was first described as a similar disease to
rubella, there was disagreement about whether it actually existed or
whether doctors were simply misdiagnosing a different illness. Since
viral and bacterial testing has become possible, no organism has been
found that could explain a specific “fourth disease”.

It is very common for children to get non-specific “viral rashes”. It is

likely that “fourth disease” was used to describe these non-specific viral
rashes that are now understood to be caused by many potential viruses.

SSSS is common enough to warrant it’s inclusion as a rash condition of

relevance in children—of course, not a virus, but a bacteria.

Fifth Disease: Parvovirus B19 Fifth Disease

“Slapped cheek syndrome” and Erythema infectiosum.
Infection starts with mild fever, coryza and non-specific viral symptoms such as muscle aches and
lethargy. After 2 – 5 days the rash appears quite rapidly as a diffuse bright red rash on both cheeks,
as though they have “slapped cheeks”. A few days later a reticular or lacy mildly erythematous rash
affecting the trunk and limbs appears that can be raised and itchy and could last as long as
3 weeks.
The illness is self limiting and the rash and symptoms usually fade over 1–2 weeks. Healthy children and adults have
a low risk of any complications and are managed supportively with plenty of fluids and simple analgesia. It is
infectious prior to the rash forming, but once the rash is present, they are no longer infectious and do not need to
stay out of school.
Patients that are at risk of complications include immunocompromised patients, pregnant women and patients with
hematological conditions such as sickle cell anaemia, thalassaemia, hereditary spherocytosis and haemolytic anaemia.

Adult women are more likely to develop a self-limited acute arthropathy (sometimes without the rash). Individuals at
risk for severe problems are those patients who are immunocompromised, and sickle cell anemia patients who are at
risk for transient aplastic crisis. In fact, Parvovirus B-19 infection is the only infectious cause of transient aplastic
crisis and is believed to be the cause in over 80% of patients with sickle cell disease.

Sixth Disease: Roseola Infantum, Exanthema Subitum

Roseola is caused by human herpesviruses 6 (HHV-6)
and affects infants and children younger than three
years of age. It is characterized by the abrupt onset
of high fever lasting one to five days, children often
appear well with little to no focal clinical signs except
possible mild cough, rhinorrhea, or mild diarrhea.
Once the fever resolves, an erythematous macular to
maculopapular rash usually appears, starting on the
trunk and spreading peripherally.
This rash is similar in appearance to that of rubeola
(measles). In contrast with roseola, the rash
associated with measles starts on the face (usually
behind the ear) or mouth (Koplik spots) and moves
downward.

Children with roseola usually appear well, whereas

those with measles are typically more ill-appearing.
Roseola is a self-limited illness requiring no
treatment, and the diagnosis is clinical.

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Characteristics of Some Common Rashes of Childhood Varicella-zoster--Chicken pox/Shingles

Chickenpox is an airborne disease spread worldwide by coughing, sneezing, and contact with skin
lesions. Symptoms begin 10 to 21 days after exposure with the average incubation period about 2
weeks. Chickenpox results in a skin rash forming small, itchy blisters that scab over, it typically
starts on the chest, back, and face and then spreads, accompanied by fever, fatigue, pharyngitis, and
headaches, usually lasting 5 to 7 days. People are contagious 1 to 2 days before the rash appears
until all lesions are crusted over. Complications include pneumonia, encephalitis, and bacterial skin
infections. The disease is more severe in adults than in children. Shingles follows many of the same
rules but typically leads to a blistering rash that may burn, tingle, or itch, even if there no blisters
are present at first. Shingles may involve clusters of fluid-filled blisters that break easily and weep
fluid and/or a very contagious rash that emerges in a band-like pattern, most commonly on the
torso.

Fever Therapy/Hydrotherapy Benefits of Fever

“Give me the power to induce fever and I will cure all diseases” Parmenides (ca. Enhances the effects of interferons
540-480 B.C.)
Inhibits the growth of some organisms
“Fever is a mighty engine, which nature brings into the world for the conquest of Enhances the performance of
her enemies” Sydenham (1624-1689)
Phagocytes
Fever as the imminent sign of infectious diseases has been used as a diagnostic
indicator since ancient times. It is one of the oldest nonspecific responses to
Specific immune response
infection, both in vertebrates and invertebrates. Accelerates tissue remodeling/repair
Temperature rise during fever establishes a cascade of host defense mechanisms
that increases host survival and induces T cell proliferation and differentiation, Adverse Effects of Fever
secretion of interferons (IFNs), antibodies and neutrophil migration. Fever as a Denatures proteins
part of the acute-phase reaction and the role of cytokines in thermoregulation
have been reviewed extensively.
Inhibits nerve impulses

Mechanism of Fever Production Fever - Myths Versus Facts

Many parents have anxiety about fevers, thinking the fever will hurt their
IL-1 or other pyrogens like bacterial toxins or antigen- child. The vast majority of fevers are harmless and often helpful-hydration
is critical.
antibody complexes stimulate hypothalamus to About 80% of children who act sick and feel warm do have a fever. If
secrete prostaglandins that reset the hypothalamic you want to be sure, take their temperature. These are the cutoffs for fever
thermostat using different types of thermometers:
•Rectal, ear or forehead temperature: 100.4° F (38.0° C) or
higher
CNS response initiates increase in temperature through •Oral (mouth) temperature: 100° F (37.8° C) or higher
Muscle contractions (shivering, rigors) •Under the arm (Armpit) temperature: 99° F (37.2° C) or higher
Increased metabolic activity
Fevers turn on the body's immune system. They help the body fight
Constriction of blood vessels (to reduce heat loss-but
infection. Normal fevers between 100° and 104° F (37.8° - 40° C) are good.
also causes chills)
Fevers with infections don't cause brain damage. Only temperatures above
Decreasing IL-1 results in body temperature 108° F (42° C) can cause brain damage. It's very rare for the body
temperature to climb this high and generally only happens if the air
normalizing through sweating, vasodilation and temperature is also very high.
decreased metabolic rate

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It's normal for fevers with most viral infections to last for 2 or 3
Febrile Seizures days. When the fever suppressant wears off, the fever will come
back. It may need to be treated again. The fever will go away and
Only 4% of children have seizures associated with fever. not return once the body overpowers the virus. Most often, this is
day 3 or 4.
These seizures are scary to watch, but they generally stop within 5 minutes without If the fever goes high, the cause may or may not be serious. If the
causing any permanent harm. patient looks very sick, the cause is more likely to be serious.
Fevers only need to be treated if they cause discomfort, which is usually if they go
How a person presents is what's important. The exact
above 102° or 103° F (39° or 39.5° C).
temperature number is not.
The brain has a thermostat. Most fevers from infection don't go above 103° or 104°
Oral temperatures between 98.7° and 100° F (37.1° to 37.8° C) are
F (39.5°- 40° C). They rarely go to 105° or 106° F (40.6° or 41.1° C). While these are
not low-grade fevers. These temperatures are normal. The body's
"high" fevers, they also are still harmless.
normal temperature changes throughout the day. It peaks in the late
With treatment, most fevers only come down 2° or 3° F (1° or 1.5° C). afternoon and evening. A true low-grade fever is 100° F to 102° F
(37.8° - 39° C) .
Fevers that don't come down to normal can be caused by viruses or bacteria. The
response to fever medicines tells us nothing about the cause of the infection.

Nutritional considerations
Nutritional Considerations
Simple sugars tend to make all of these conditions worse.
Pain makes swallowing difficult, so rough textured foods can be problematic • Bottles and sippy cups become problematic here…as the child lays
back and suctions sugars and bacteria are able to colonize into the
Soups, porridges, smoothies, juices (watching sugar content)
meatus of the Eustachian tube, contributing to ear infections.
Frozen Emergen-C, Airborne, etc. is helpful, and soothing to a throat as
homemade popsicles • Good quality proteins are important, cheese, dairy, soy and wheat
can contribute to a more sticky and globular quaternary structure to
Warm/hot teas with a bit of honey and ginger can be wildly helpful
the mucous.
Fermented ‘Ginger Bug’ is often very helpful for chronic thrush and acute
• N-Acetyl-Cysteine-300-1000 mg/day can be a great mucolytic, creating
infections
more planar and easier to expectorate mucus.
In a jar on top of the refrigerator—1 tbsp ground ginger (with peel), 1 tbsp
• Avoiding simple sugars can be profoundly helpful
sugar, 2-4 ounces of water, cover with a towel or cheese cloth and let it sit
for a day or two to ferment…you will hear it bubble and fizz. Keep adding • Staying hydrated can be very helpful
water, sugar and ginger to keep it growing, ultimately expanding the • Consider environmental mold exposure if condition persists
volume to 1 liter bottles and allowing to continue fermentation.
• Supplementation with Vitamin A, 10,000-25,000 ius/day
Store at room temperature in a pressurized bottle

N-Acetyl-Cysteine Botanical Medicine Considerations

An antioxidant component of Glutathione
There is no shortage of botanical agents that share a myriad of host immune
Plays a protective, reducing role in the compound
stimulating effects as well as antimicrobial influences. Nearly every system of
A major reagent in Phase ll sulfation reactions
crucial for appropriate detoxification, including
traditional medicine from every culture on the planet has their favorites, from
histamines and heavy metals Glycyrrhiza, Grindelia, Sambucus, Ocimum, Eupatorium, Mentha, Melissa,
Hypericum and Azdirachta.
Improves antibody production, esp. IgA It may suffice to say that frequent consumption of warm herbal beverages is
Displays significant antiviral sensorially pleasing and impactful of immune systems while helping to mitigate
activity against influenza viruses some of the presenting symptoms of a viral infection. Inasmuch as they contribute
mucolytic to hydration, manage nausea, encourage expectoration and occupy the mind, they
are immeasurably helpful. A little honey and a crazy straw will entice even the
Exhibits bactericidal properties, breaks down bacterial biofilms of clinically most reluctant toddler to consume some Melissa, Sambucus or Zingiber tea.
relevant pathogens including Pseudomonas aeruginosa, Staphylococcus aureus,
Enterococcus faecalis, Enterobacter cloacae, Staphylococcus epidermidis and The value of many botanical medicine interventions is their safety profile. Plants
Klebsiella pneumoniae with rich terpene profiles and high amounts of volatile constituents are most
600-1200 mg/day helpful. Essential oils are helpful when diffused into the environment and added
to steams and baths.

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Hydrotherapy considerations
Botanical Medicine Considerations
Wet sheet Packs and Wet Socks are very helpful measures
Throat spray-Topical applications of botanical agents like:
Salt water gargle-a hypertonic solution of salt (1-2 tablespoons of salt per quart
Echinacea, Zanthoxylum, Spilanthes, Rudbeckia, Anemopsis, and Piper methysticum
of water)—iodized salt may be more effective
can be topically soothing as well as stimulating to local immune response.
Carrot or potato poultice wrapped around the throat with a scarf or a towel.
Lymphatic alteratives can be applied topically as well as internally with specific
Using a damp material helps promote better circulation into and out of the
indications:
tissues of the throat. As the poultice warms to body temperature, cool it down
Baptisia tinctoria-there is a particular duskiness of a bluish or purplish hue of the with a cold water rinse. Can be done throughout the day and night.
skin and mucus structures—consider in cases of cellulitis.
Alternating hot-cold packs to the neck can help reduce acute swelling
Scrophularia-lymphatic swelling with ulceration of the mucus membranes
Hot foot baths and cold on the back of the neck can be really helpful for
Stillingia-Mucosa red, glistening and without secretion delirium in fevers
Phytolacca-Chronically swollen tonsils and cervical lymph nodes Chest rubs are often very soothing and help with circulation
Most of these botanicals are dosed on the order of 3-5 drops 4-5 times a day…they are Vaporub/volatile terpenes
very conducive to be put in throat sprays where the child can administer something
Mustard plaster—can be irritating to skin
soothing and helpful as often as they might see fit, takes an uncomfortable and
disempowering situation, being ill, and allows a sense of agency.

Glycyrrhizic Acid
Triterpenoid saponin from Glycyrrhiza glabra-licorice Anemopsis californica--Yerba mansa
Hydrolysed to the biologically more active compound glycyrrhetic
Native to the Southwestern part of North America. It is a perennial flowering
acid, which inhibits the enzyme 11 beta-hydroxysteroid dehydrogenase
plant that blooms in spring. The rhizome is the most common part of the plant
leading to increased cortisol levels.
that is used for its medicinal value.
The result is a hypermineralocorticoid effect of cortisol as it binds
with the same affinity as aldosterone to the mineralocorticoid The name Yerba is a Spanish word which means herb owing to the herbal
receptor. properties of this plant. Although the word Mansa means “tranquil” in Spanish,
The inhibitory effect on 11 beta-hydroxysteroid dehydrogenase is the Yerba Mansa plant does not actually have any sedative properties.
reversible; however, depression of the renin-angiotensin system may It has a reputation for use as an antimicrobial treatment for swollen gums and
last several months. Used in the clinical treatment of hepatitis, sore throats, and many other diseases of the mucus membranes. Yerba Mansa
bronchitis, gastric ulcer, AIDS, certain cancers and skin diseases. is used as a poultice that can be directly applied to wounds, boils and burns. It
has a history of use as an anti- inflammatory that can be used to treat pain and
It exerts anti-microbial and anti-inflammatory activity through several swelling of arthritic joints, and fascial pain. It is very rich in aromatic terpenes
different mechanisms. and very soothing to a sore throat and inflamed lungs.
Topically, very helpful to inflamed mucus membranes.
Dosage of tincture is 15-20 drops 2-3 times a day
10-20 mg/day through a nebulizer or nasal spray glycyrrhizic acid
represents a safe dose.

Eriodictyon angustifolia--Yerba Santa Hyptis emoryi-Desert Lavender

Native to the Desert Southwest of the US, a member of the mint family
Native to the southwest US it is a warming, diffusive and drying
and full of volatile terpenes that are anti-microbial and anti-
botanical with a sweet flavor. As a tea or a tincture it is helpful in viral
URI’s and allergic asthma. It is generally anti-microbial and anti- inflammatory. It grows freely and wildly all over the southwest and
inflammatory. makes a great landscape medicinal plant.
Particularly helpful in respiratory conditions, coughs, viral infections
Dosage is 20-40 drops of tincture (1:5) 3-5 times a day like colds, flus, covid 19, asthma and allergies.
It mixes well with other respiratory agents.
The hot tea has a distinctly diaphoretic action and is nicely
The tea is full of volatile constituents that are soothing and expectorant.
relaxing…although too much will cause nausea and vomiting. The tincture (1:5) dosed at 10-30 drops 3-5 times a day combines
nicely with other respiratory agents.
Along with Bursera microphylla, Hyptis is a spiritually significant
plant to the Seri/Comcaac people. As a protection as well as a
connection to the spirit world.

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Atopic Dermatitis/Eczema

Atopic Dermatitis-eczema
The "itch that rashes" due to the rash that results from scratching or rubbing, the hallmark of
eczema is dry, itchy skin prone to infections.

Research shows there is a genetic component to eczema with a common mutation in the gene
responsible for creating the tough, flat corneocytes that form the outermost protective layer of
the skin. In a patient with normal skin cells, the corneocytes are tightly packed in an organized
manner. A patient with this mutation will have a dysfunctional skin barrier due to the
haphazard organization of the skin cells. This dysfunction causes a "leaky" skin barrier, allowing
water loss and decreased protection from harmful substances.

People with eczema also have reduced numbers of β-defensins in the skin. β-defensins are host
defense peptides vital for fighting off certain bacteria, viruses, and fungi. A decrease in these
peptides leads to increased colonization and infection, especially with Staphylococcus aureus.

Psoriasis
Psoriasis is a chronic proliferative and inflammatory condition of the skin that is characterized
by erythematous plaques covered with silvery scales, particularly over the extensor surfaces,
scalp, and lumbosacral region.
The pathophysiology of psoriasis involves infiltration of the skin by activated T cells which
stimulate the proliferation of keratinocytes. This dysregulation in keratinocyte turnover results
in the formation of thick plaques. Other associated features include epidermal hyperplasia and
parakeratosis. In addition, the epidermal cells fail to secrete lipids which results in the typical
flaking and scaling skin.

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Specific or Adaptive Immune Response is dependent on non-specific immune response

Innate Immunity
First line of defense against pathogenic microbes
Physical infrastructure exists before exposure to potential
pathogens
physical barriers/tight junctions
Found in plants, insects and vertebrates

3 Essential Functions
Initial resistance to microbial infiltration
Eliminates damaged cells and initiates the process of
repair
Invokes adaptive immune response

2 major categories of active response

Inflammation
Antiviral defenses

Includes Dendritic cells, Macrophages, NK cells and

complement cascade

Dendritic Cells Specific or Adaptive Immune Response

Specific immunity has the qualities of learning, adaptability, and memory.
Antigen-presenting cells (APCs also known as accessory cells)
Their main function is to process antigen material and present The cellular component of specific immunity are the lymphocytes (B-cells,
it on the cell surface to the T cells T-cells and Dendritic cells)
They act as messengers between the innate and the adaptive
B-cells mature in bone marrow and produce Abs
immune systems T-cells mature in the Thymus and Lymph glands and represent the
cellular response system

The soluble component is composed of immunoglobulins, or antibodies, of

which there are five classes, IgG, IgM, IgE, IgA and IgD

Organs of the Immune System Thymus Gland

Primary: Thymus and Bone marrow where lymphocytes are matured.
Secondary: Lymph nodes, spleen, mucosal-associated lymphoid tissues (MALT), and gut- Role of cytokines in T cell
associated lymphoid tissue (GALT) development.
Tertiary: Cutaneous associated lymphoid tissues (CALT). CD, cluster of
differentiation;
DN, double negative;
DP, double positive;
IL, interleukin;
Treg, regulatory T cell.

T cell development in the thymus.

CD, cluster of differentiation;
CMJ, corticomedullary junction;
cTEC, cortical thymic epithelial cell;
DN, differentiation;
DP, double positive;
mTEC, medullary thymic epithelial cell;
SP, single positive.

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Thymosins Thymosin α-1

A family of biologically active molecules with hormone-like properties.
First isolated from the thymus gland and described in 1966 by AL Goldstein Thymosin α-1 is a major component of Thymosin Fraction 5
and A White. and is responsible for restoring and modulating immune
Thymosins play a significant role in establishing immunity and modulating function, particularly cell mediated immune function.
several growth factors, cytokines and chemokines.
In the early 1970s, preclinical studies established the immuno-restorative Recent studies showed that Thymosin Alpha-1 molecule
effects of a partially purified thymosin preparation termed thymosin increased major histocompatibility complex (MHC) class-1
fraction 5 (TF5) from calf thymus glands that provided the scientific and Toll-like receptor expression as well as cytokine
foundation for the first clinical trials with TF5 in 1974. production, suggesting an immunoregulatory role.
TF5 was effective in turning on the immune systems of a number of
children with DiGeorge syndrome and other thymic dysplasias. These trials It is an FDA approved medication under the trade name
led to further interest in the active components in TF5 and to the chemical zadaxin after it received orphan drug approval status. It is
characterization of the biologically active thymosins. widely used and studied in the treatment of multiple types of
cancer, viral illnesses and autoimmune conditions.
Several of these molecules are showing significant promise in the clinic in
the areas of cancer, infectious diseases and wound healing. TA 1 is plays a role in modulating immune response by
stimulating T-cell differentiation.

Ceanothus
Thymosin β4 The most abundant member of the thymosin family of americanus/greggii/fendleri
proteins, expressed in many different tissues. Red Root
Thymosin β4 is the principal G-actin sequestering molecule
Indicated historically for lymph system; splenomegaly; acute
in mammalian cells, playing an important role in the
organization of the cytoskeleton.
tonsillitis and pharyngitis.
Used as a gargle in acute pharyngitis and tonsillitis
Thymosin β4 I involved in: Fibrocystic breast disease and acute mastitis
promotion of cell migration, blood vessel formation, survival Lymphadenitis, in chronic conditions
of cells, differentiation of stem cells, modulation of cytokines, Mononucleosis, with widespread and inflamed nodes
chemokines, and certain proteases as well as up-regulation of
matrix molecules and gene expression. Three triterpenes (ceanothic acid, 27-hydroxy ceanothic acid and
ceanothetric acid) have demonstrated growth inhibitory effect against
Notably, thymosin β4 is secreted from platelets and aids in the Streptococcus mutans, Actinomyces viscosus, Porphyromonas
formation of crosslinks with fibrin in a time- and calcium- gingivalis, and Prevotella intermedia
dependent manner in the process of clot formation.
Betulin and Betulinic acid constituents are active as anti-
inflammatory, anti-tumor agents as well as modulating the immune
system.

Scutellaria baicalensis-Huang Qin PHYTOLACCA AMERICANA

POKEROOT
Also known as Baikal skullcap or golden root
Poke has a long tradition of use in western botanical medicine for lymphatic
swelling, respiratory conditions and chronic illness. It is potentially toxic in larger
In TCM, it is well established as an agent that clears the heat of amounts, the toxicity manifesting as gastroenteritis, vomiting and diarrhea.
inflammation, dries dampness, and also acts as a mast cell stabilizer Therapeutic effect can be achieved with doses of 15-30 drops 3-4 times per day.
Studies have shown that, presumably through the action of pokeweed mitogen, the
Exerts some anti-inflammatory activity through inhibition of plant extract has a measurable effect on lymphocyte proliferation and induces
lymphoblastic transformation in B-cells. It is a well- regarded lymph mover by
lipoxygenases, interleukin 1B and IL-4, and prostaglandin E2 modern herbal practitioners.
Poke oil and castor oil, mixed 50:50, can be used with good effect topically on
Wogonin, Bacalein and Baicalin are considered to be its most anti- congested and swollen breast tissue and any enlarged lymph nodes or areas of
inflammatory constituents. congestion and pain.
Pokeweed mitogen is a glycoprotein lectin that impacts both T-cells and B-cells at a
Baicalein has potential in reinforcing remyelination of nerve wide range of dosages, the whole plant preparation exhibits anti-viral activity and
sheaths. can be useful in helping the body eliminate microbial offenders. Also helpful in
reprogramming B-cell production of auto-reactive antibodies and motivating
lymphatic structures to weed such antibodies from circulation.
Dosage 500 mg-2gms/day of powder or 1-4 ml of tincture (1:2)
Dosage of a 1:5 tincture 5-15 drops 2-4 times per day

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ZANTHOXYLUM AMERICANUM
PRICKLY ASH Low Dose Naltrexone-LDN
Introduction
The use of low doses of naltrexone for the • Naltrexone is a mu opiate receptor antagonist US FDA
Traditionally used in the treatment of fevers, ague, and poor circulation. treatment of autoimmune conditions enjoys a approved for treatment of opiate addiction
The fruits are considered more active than the bark, they are also antispasmodic, worldwide following. • More recently naltrexone in low dose was found to enhance
carminative, diuretic and antirheumatic. The root and bark can be used for toothache. There is overwhelming anecdotal evidence, the effects of opiate agonists1
The berries are more stimulating than the bark and not as bitter. Prickly Ash is indicated that low dose naltrexone not only prevents • In 1985 Dr. Bernard Bihari found that HIV infected patients
in atonic states of the mucous membranes, with relaxation and hypersecretory states. In relapses but also reduces the progression of had low levels of endogenous endorphins and hypothesized
larger doses it is indicated in depressive states of the nervous system, with capillary the disease. that increasing their levels would be beneficial
congestion and sluggish circulation, dryness of the mouth and pharynx, gastric It is proposed that naltrexone acts by reducing • Dr. Bihari began using a low dose of 4.5 mg naltrexone taken
deficiency with hyposecretory states, abdominal distention and gas, uterine cramping apoptosis of oligodendrocytes and interfering nightly in the treatment of HIV infected patients with the goal
and pain, and neuralgia. with excitatory neurotoxicity of glutamate on of “normalizing” endogenous endorphin levels
neuronal cells. • Anecdotal reports suggest that this low dose of naltrexone
Prickly Ash is an important remedy in disorders of the mouth and throat, as well as of (LDN) might also benefit MS patients
the digestive tract. Dosage usually begins at 3 mg before bed and • A small (N=17) open label study in Crohns disease found that
is raised in 0.25-0.5 mg increments every week LDN improved active disease as measured by the Crohns
The dosage of 1:5 tincture is 10-30 drops 2-3 times a day to 2 weeks to 4.5 mg before bed. disease activity index2
This plant is often not sustainably harvested…did I mention the effectiveness of the
berries?

Materials and methods

Randomized, double-blinded, single center, double-
crossover, single center, clinical trial
1st Treatment period 2nd Treatment period
4.5 mg Naltrexone at night 4.5 mg Naltrexone at night
Blocked Randomization
By Treatment Group: n = 40
1: IFN
2: GA n = 40
3: No DMT Placebo at night Placebo at night

MSQLI

0 8 9 17
Duration of study (weeks)

Inclusion criteria Exclusion criteria

Saponins in Licorice Cortisol—”Licort” and ”Eleutherocort”
• Clinically definite MS by current
International Panel Criteria
• Start of a disease modifying therapy
within 3 months of entry in the trial
I produce this in my office by adding a specially prepared
• 18 andand micronized
75 years of age • Planned start of DMT during the
Triterpene skeleton has 30 carbons in five rings: ‘pentacyclic’ cortisol acetate to a 1:1 fluid extract of Glycyrrhiza• glabra or Eleutherococcus
Willingness to not change or start clinical trial
disease modifying or symptomatic • Pregnancy
senticosus in a 3% concentration, this produces a tincture that contains 1 mg of
Most have 3 – 5 sugars attached, occur as complex mixtures in all plant cortisol per drop.
therapies of MS during the trial • Current chronic opioid agonists use
• Patients currently on a disease • Patients currently on both interferon
parts The average daily equivalent of cortisol output for most people
modifying is 25-30
therapy should mg.
not anticipate and glatiramer acetate
Many are anti-inflammatory compounds and the saponins disrupt the When a patient is given more than this quantity it canchanging
be too or
medication
discontinuing this
suppressive
during the 17 week andstudy • Patients currently taking LDN
disruptive of normal physiology. This is not to say that some people aren’t able • Patients currently taking
formation of biofilm • Patients not currently on a disease immunosuppressive medications
to produce quantities of cortisol that are far above thismodifying therapy
level, just that from a
Anti-inflammatory (synergistic with the flavanones) • For women of
supplementation basis, we may not want to risk suppression or disruption inchildbearing potential,
willingness to use a barrier method of
Inhibit secretion of stomach acid our interventions. I have found that replacing an existing steroidduring
contraception regimen with
the trial
an equivalent dosage of cortisol tincture makes it far easier to wean the patient
Inhibit deactivation of cortisol Trial Participants
down later, with very little to no ill effects after discontinuation.
• 80 subjects were enrolled
Responsible for raising blood pressure w/excess ingestion (sodium & water For those patients who seem to need some kind of cortisolic augmentation,
– 9 withdrew I
voluntarily, 1 withdrew secondary to unrelated medical condition
retention, potassium excretion, diuresis) will add the licort or eleutherocort tincture to their existing botanical
• 70 completed both treatment periods, 60 with complete data
preparation and dose it 5 drops 4 times a day. I find that– it10mixes
subjectsquite
droppedwell
secondary to incomplete data
Immunostimulating, antihepatotoxic, antiviral, disrupts biofilm with any preparation that would benefit from the addition •of 4licorice
data management
or errors, 6 uncompleted surveys
Eleutherococcus. " # RR SP PP PR IFN GA No DMT
36 24 31 13 15 2 14 14 32

Outcome Measure: The Multiple Sclerosis Quality of Life Inventory (MSQLI)

Statistics
• Pre-specified analysis adjusted for sex, age, disease course (RR, SP, PP, PR), current
treatment (IFN, GA, no DMT), race, baseline score and study drug order using a time
series regression equation modeled for random effects and clustered by study subject
• The only baseline covariate that had a statistically significant impact on the model was
the baseline score

The stratum corneum is composed of terminally

Ceramides differentiated and enucleated corneocytes that
Ceramides and sphingolipids are long chain reside within a lipid matrix, like "bricks and mortar."
fatty acid components of the stratum corneum Cholesterol, free fatty acids, and ceramides form the
lipid mortar, a water-impermeable barrier that
layer of the skin. The composition of ceramides, prevents dehydration and microbial invasion.
sphingolipids and other lipids is important for The epidermal lipid matrix is composed of a
the formation of a healthy skin barrier, which mixture of ceramides (~50%), cholesterol (~ 25%),
and free fatty acids (~15%).
may be compromised in skin conditions such as
atopic dermatitis and psoriasis. Ceramides and
sphingolipids are also involved in the control of
keratinocyte proliferation and differentiation, as
well as modulating the immune system within
the skin. Marked clinical benefits of topical
ceramide products in patients with atopic
dermatitis or psoriasis.

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Hyaluronic Acid/Glycyrrhizic acid Hydrogel

Per 100 mls of finished hydrogel:
10 mg/ml Hyaluronic acid—80 ml—800 mg
5 mg/ml Glycyrrhic acid--20 ml-100 mg
Ceramide x-blend-4.5 mls (4500 mg)
Allantoin 1%--1000 mg

Mix each gel in water separately, a fast spin on a magnetic stirrer

or extrusion through a luer lock to luer lock adaptor and two syringes.
Once the gel has formed, the two can be folded together and the
ceramides added, making a creamy gel.
Make the allantoin into a slurry with a small amount of water and mix
into hydrogel
It is remarkable for patients with eczema and psoriasis…
If necessary, licort can be suspended in cyclodextrin and added to the
hydrogel. With all due caution.

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Surface Eruptions: A Primer on Skin Rashes and Botanical Medicine Approaches to

Their Treatment
Dr. Kenneth Proefrock

Rash is a very broad medical term defined as a "widespread eruption of skin

lesions." They can vary widely in appearance, with causes ranging from insect bites to
HIV and reactions to medications, they can affect one small part of the body or cover
large areas. Rashes can be dry, moist, bumpy, smooth, cracked, or blistered. They can
involve pain, itching, and color changes. There is a vast spectrum for how skin rashes
manifest in patients with more and less pigmentation and this is an arena of medicine
fraught with controversy (most skin rashes are presented in photos of less pigmented
people in the medical literature, but most skin manifestations of STI's are presented with
photos of people of with more pigmentation--a significant effector of bias when that
distortion is presented to medical students). Some rashes will clear up on their own, some
respond to herbal remedies, and others might be a sign of something more serious that
needs to be addressed differently. We will discuss many of the reasons why skin rashes
occur and the underlying mechanism for their presentation, including skin infections from
bacterial, fungal, viral, or parasitic infections, allergies, and medications. We discuss the
internal and topical botanical medicine interventions and their rationale, we also discuss
concepts of suppression vs. healing.
Dermatology is arguably the most allopathic (allo-'other' or 'opposite', pathy-
suffering) of the medical specialties. I recall one of my dermatology professors in
Naturopathic medical school summing this science up in the following way. “In regard to
rashes, if it’s wet, make it dry; if it’s dry, make it wet. If the condition persists, begin
administration of steroids.” In natural medicine, we recognize that a skin rash is usually
superficial manifestation of a potentially greater underlying disorder. Suppression of this
manifestation will often result in a worsening of some deeper pathology. A classic
example that most of us have seen in clinical practice is the steroidal suppression of
eczema in young children resulting in a later manifestation of asthma. Skin disorders can
also be some of the most frustrating conditions for any clinician to be met with, not to
mention for which the patient contends. The chronicity and slow resolution of these
conditions make it sometimes difficult for the patient to maintain faith in non-suppressive
processes. Those patients experienced with the quick fix of conventional medical
interventions, will often become discouraged and/or non-compliant and not follow the
process of elimination that we prescribe, especially when a red, burning, itchy rash is
becoming temporarily worse. This can reflect negatively on the practitioner and is acutely
true when a patient with a rash has been treated with botanical medicines for several
weeks with minimal results, goes to a dermatologist and two days into a prednisone taper,
the rash is completely resolved. There are precious few resources available to the
practitioner of alternative medicine for means of dealing with these seldom life
threatening but always quality-of-life threatening conditions. I refer the reader to the
references section of this paper for those resources that have been invaluable for me in
my practice. I am hopeful that this discussion will itself become such a resource,

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amenable to updates and additions as we become more aware of and deepen our
understanding of skin conditions.
We will discuss briefly the major features of the pathology, a description the
lesions and causes for them. Then we will discuss potential strategies for resolution of the
condition. What is presented here is not meant to be used in protocol fashion, rather as a
strategic base for the practitioner to develop their own individualized strategies to best
meet their patient’s needs. We could spend days on the subject of dermatology; this
discussion is certainly not intended to be all-inclusive, so we start with common
manifestations of skin rashes and by creating some categories of skin diseases. There are
those conditions that are related to microbial influences, these include bacterial related
diseases like acne, impetigo and cellulitis, fungal infections, and viral diseases such as
warts, measles, mumps and rubella. We will also include conditions that are due to a
dysregulation of immune response; these include hypersensitivities like urticaria and
eczema. These categories of conditions are by no means mutually exclusive to one
another. As we shall see there are many instances where one manifestation evolves into
another, these categories provide us with a frame of reference.
Naturopathic medicine frequently emphasizes that “the microbe is nothing, the
milieu is everything”, addressing the terrain within the body and in the skin makes far
more sense than killing the opportunists who take advantage of that terrain. Recognizing
that the human body is a largely water-soluble terrain with special mechanisms in place
for dealing with fat-soluble substances is an important place to begin. The skin is one of
the major organs of elimination for the whole body with the pores of the skin being the
actual route of elimination. What the body is eliminating becomes food for whatever
microorganisms are living in those pores and other surface irregularities. Hormones are
an example of a fat-soluble material that, when in excess, either from endogenous
production, or from exogenous intake, can be excreted through the skin and provide a
more favorable environment for the growth of many microbes. The ability of the liver to
process fatty material (phase 1 and phase 2 activity) determines how much will end up
being excreted through the skin. The relative degree of oxidation of those fatty substances
while being processed through the body also has a bearing on how irritating they will be
when deposited within the pores of the skin.
For any microbially induced or mediated skin condition, diet becomes the first
point of order when trying to change the terrain of the body. Generally speaking, a diet
low in processed foods, high in fiber, with special consideration of the quality of the fats
that one is consuming provides a decent dietary foundation. Avoiding simple
carbohydrates (some dermatologists refer to acne as skin diabetes) provides less sugar
substrate for the overgrowth of skin bacteria and fungi. Consider food sensitivities, the
use of an elimination diet and the patient’s digestive capacity (enzymes vs. HCl). For
some conditions, like acne and some cases of eczema, food sources of hormonal
modulators, lignans from flax and root vegetables, beta-sitosterol, and isoflavones from
soy are helpful. Increasing consumption of anti-inflammatory and anti-microbial food
items like garlic, turmeric, cumin, essential fatty acids and cruciferous vegetables. It is
important to emphasize monounsaturated fats like olive oil, nuts, and avocado, and to

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avoid saturated fats (too solid), hydrogenated fats (too mutated) and polyunsaturated fats
(too reactive).
Bacterial overgrowth tends to present with inflammation, redness and irritation
leading to pain. Acne vulgaris is a good example of a process that can be described as a
chronic inflammatory dermatosis affecting the hair follicle. It is extremely prevalent in
middle to late teenage years, affecting both males and females, with males typically
afflicted with a more severe manifestation of the disease. Acne is seen in all races but
seems to be milder in those of Asian ancestry. The pathogenesis of acne is considered to
be due to the bacterial lipases of Cutibacterium acnes (formerly Propionibacterium
acnes) which break down the sebaceous oils, liberating highly irritating fatty acids inside
the hair follicle, inducing the initial inflammatory phase. Its manifestation varies
tremendously between individuals and may be induced or exacerbated by drugs
(corticosteroids, testosterone, gonadotropins, contraceptives, iodides, and bromides),
occupational contacts (cutting oils, chlorinated hydrocarbons, and coal tars), and
occlusive conditions such as heavy clothing, tropical climates, and the application of
comedogenic topical agents (make-up, lotions, ointments, etc.) The pathogenesis of acne
vulgaris involves the interaction of several host factors, including the stimulation of
sebaceous glands by circulating androgens, dysbiosis of the pilosebaceous follicle
microbiome, and cellular immune responses. In addition, other factors such as genetics
and diet may also influence the development and progression of the disease1. The micro-
comedo (the pimple) serves as the primary lesion and is the precursor for all clinical
manifestations of acne vulgaris. It is characterized by a small, hyperkeratotic plug
primarily composed of corneocytes and located in the lower region of the follicular
infundibulum. Micro-comedones gradually evolve and develop into other acne lesions,
which include closed comedones (whiteheads), open comedones (blackheads), and
inflammatory papules, pustules, and nodules. The progression of micro-comedones into
other types of acne lesions has been theorized to involve the following 4 primary
pathogenic events:
• Increased sebum production (seborrhea)
• Follicular hyper-keratinization
• Overgrowth of Cutibacterium acnes-Anaerobic diphtheroid that naturally exists as
part of the skin flora.
• Inflammation
The gradual accumulation of keratinous material and sebum converts a micro-
comedo into a closed comedo (pimple to a whitehead). The follicular orifice can
gradually expand, resulting in the formation of an open comedo (blackhead) where
oxidized lipids and melanin within the comedo contribute to its characteristic dark black
color. C acnes contributes to the development of inflammatory pustules and papules.
Eventually, follicles rupture with the release of bacteria, keratin, and proinflammatory
lipids into the surrounding dermis, exacerbating the inflammation and creating nodules
within the skin.
Most patients with acne vulgaris typically have normal androgen levels in their
body. However, in certain conditions such as congenital adrenal hyperplasia, polycystic

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ovarian syndrome, and adrenal or ovarian tumors, excessive androgen production is

produced in the body, ultimately leading to a proportionate severity of acne. The role of
androgens in the development of acne involves several modifiable mechanisms2:
• The adrenal glands and the gonads secrete androgens.
• Sebaceous glands can also synthesize androgens through the conversion of DHEA
to testosterone via the action of enzymes whose effects can be modified by diet
and botanical medicines.
• 5-alpha reductase in the sebaceous gland converts testosterone to 5-alpha-
dihydrotestosterone (DHT)--which is up to 5 times stronger in its androgenic
potential.
• Sebaceous glands and the outer root sheath keratinocytes of the follicular
epithelium have androgen receptors that bind DHT and testosterone.
• Androgens stimulate the growth of sebaceous glands and increase their secretory
function, leading to seborrhea and acne formation.
• Seborrhea provides a growth medium for C acnes from which they hydrolyze
triglycerides in sebum, as a nutrient source, into free fatty acids and glycerol.

The development of acne involves several factors associated with C. acnes and the
immune response as listed below3,4:
• The acne-associated strains of C. acnes have been found to possess a heightened
capacity to stimulate the pro-inflammatory cascade, specifically involving TH17
cells which stimulate secretion of cytokines such as interferon (IFN)-gamma and
interleukin (IL)-17, which are promotors of inflammation. In contrast, the strains
associated with healthy skin have been shown to stimulate TH17 cells to produce
the anti-inflammatory cytokine IL-10.
• Antibiotic resistance in acne has been linked to acne-associated strains of C
acnes, which form biofilms within the follicles.
• C. acnes stimulate the innate immune response to produce IL-1 by activating the
nod-like receptor P3 (NLRP3) inflammasome in human sebocytes and monocytes.
• C. acnes activates toll-like receptor-2 on perifollicular macrophages, which
triggers the release of more pro-inflammatory cytokines such as IL-8 and IL-12.
These cytokines attract neutrophils, whose lysosomal enzymes contribute to
follicular rupture.

Many of the botanical products that have been found to be beneficial for the
treatment of acne vulgaris contain plant sterols at high doses. Botanicals such as saw
palmetto, soy products, pygeum bark, stinging nettle root, and pumpkin seed extract are
rich in plant sterols and beta-sitosterol is the most commonly occurring, it can often be
found in supplement form in your local health food store. The mechanism of its action is
believed to work through inhibition of cholesterol catabolism and modulating hormonal
influences that trigger inflammation5. Sterols block the absorption of cholesterol from the
intestinal tract and are the active ingredient in cholesterol-lowering margarine products
such as Take Control (beta-sitosterol) and Benecol (sitostanol). Sterols may also have

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benefit because they cannot be converted to testosterone in the body, beta-sitosterol

specifically inhibits 5-alpha reductase activity and interferes with androgen binding at the
site of the receptor. The recommended dose of beta-sitosterol is 20–30 mg three times a
day.
There are three well known herbal agents that play a specific role in decreasing 5
alpha-reductase activity. These agents are Serenoa repens, Pygeum africanum, and
Urtica dioica; Pygeum and Urtica have also been shown to inhibit the aromatization of
testosterone to estrogen. Beta-sitosterol is a constituent of both Serenoa and Pygeum.
Overharvesting and lack of sustainable agriculture has reduced populations of Pygeum,
and as the medically useful component is the bark of the tree, a single harvest can be
unrecoverable. Urtica dioica, stinging nettle, is a widely available plant that has been
intensively researched for its effects on hair growth, mostly related to the 5 alpha-
reductase qualities in its dried root with some studies also showing a stimulation of
dermal papilla cells. Urtica root also contains beta sitosterol which stimulates
angiogenesis by increasing vascular endothelial growth factor (VEGF) synthesis and
supports turnover of compromised skin cells5. Usual dosage of these agents looks like
100 mg/day of Pygeum, and 500-1500 mg/day of Urtica root.
The saw palmetto plant (Serenoa repens) is a small palm native to the southeastern
United States and grows wild in Florida’s natural areas. It is a slow-growing, clumping,
multi-trunked palm that typically grows 5 to 10 feet tall and spreads 4 to 10 feet wide.
The plant produces small berries that are an important food source for wildlife species
and are commonly harvested for medicinal purposes in late summer to early fall, usually
from August to October. Harvesters usually look for berries that have turned from green
to blue-black in color. Harvesting involves hand-picking the berries, which grow in
clusters on the plant. The fruit of saw-palmetto has been eaten by humans for centuries, it
was a staple food item for many of the early Native Americans of Florida, although the
taste is definitely not for everyone. The medicinal value of the fruit has been described in
scientific literature since the 1800s where it is prescribed in tinctures of the fruits and
crushed seeds and used for relief of prostate gland swelling, reduction of acne severity
and promoting hair growth. Saw palmetto berry's active ingredients include fatty acids,
plant sterols, flavonoids, and high molecular weight polysaccharides (sugars). The
perceived medical benefit from eating the berries includes inhibition of 5α-reductase I
and II, reducing DHT conversion from testosterone, and inhibition of DHT binding to the
cytosolic androgen receptors, as well as other anti-inflammatory effects, with 320 mg/day
being a decent daily oral dosage.
Although acne may be unavoidable, it can be effectively controlled through
several measures. Regularly washing one's face with a pH-balancing cleanser can help
manage acne symptoms. Avoiding high glycemic index foods, dairy-based products may
help manage acne symptoms in some individuals. Enough cannot be said about the far
reaching role that psycho-social stress can play in exacerbating acne--especially in
adolescents. Benzoyl peroxide, Salicylic acid, oral and topical antibiotics and oral
contraceptives are all used fairly commonly in conventional treatment of acne, and these
measures can be very logical for some presentations.

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Benzoyl peroxide possesses both comedolytic and antimicrobial properties. It is

available in various formulations and concentrations ranging from 2.5% to 10%.
Typically, it is applied once daily, focusing on 1 or 2 small areas during the initial 3 days
to test for any potential hypersensitivity reactions. Benzoyl peroxide should not be
applied simultaneously with tretinoin due to its oxidizing effect on tretinoin. To avoid
any reaction, benzoyl peroxide should be applied in the morning, whereas tretinoin
should be applied in the evening. It is important to note that skin irritation may occur
with benzoyl peroxide use, particularly at high concentrations. It may also have a
bleaching effect on clothing and hair. Salicylic acid is a desquamating keratolytic (it
promotes the sloughing of old, dead and dying skin cells), it is also comedolytic and
antimicrobial and available over the counter at concentrations of 1-5%.
Vitamin A derivatives such as tretinoin, tazarotene, adapalene, and trifarotene, are
often included in the initial management for patients with acne. Vitamin A effectively
targets both comedones and inflammatory papules and pustules. For patients with
predominantly comedonal acne, topical retinoids can be effective all by themselves and
are also recommended for maintenance therapy after successful treatment. Patients with
papulopustular acne can benefit from adding a topical antimicrobial agent, which can be
used in combination with benzoyl peroxide to minimize the risk of antibiotic-resistant
bacteria emerging. Topical retinoids are vitamin A derivatives that act by binding to
retinoic acid receptors (RARs) and retinoid X receptors (RXRs) within the keratinocytes.
Tretinoin, tazarotene, and adapalene are topical retinoids that primarily act upon the
RAR-beta and RAR-gamma receptors. Tretinoin also targets the RAR-alpha receptor.
Upon binding, the retinoid-receptor complexes are transported into the cell's nucleus,
activating the retinoid hormone response element, stimulating the transcription of several
regulatory genes. The skin response to this process includes the normalization of
follicular keratinization and the loosening of the cohesiveness of the keratinocytes,
thereby decreasing the formation of micro-comedones6. The topical retinoid should be
applied once daily, preferably at night, due to the reported photo-lability of vitamin A
derivatives. Before applying a retinoid, ensure that the skin is dry, apply a thin layer to
the whole affected area rather than spot-treating individual lesions, 1/2 gram or a pea-
sized amount of the medication should be sufficient to cover the entire face. The
frequency of application should be adjusted to minimize the risk of skin irritation, most
people can tolerate every other night or every third night in the beginning and, as
tolerance improves, the frequency of application can be increased. Some common
adverse effects of topical retinoids are dryness, irritation, flaking of the skin, and
sensitivity to sunlight due to skin thinning. However, these adverse effects can often be
managed using moisturizers and sunscreens. It is important to note that retinoids, topical
and oral, are not recommended for use during pregnancy, or for any female of
childbearing age, without full knowledge and consent of the potential harm.
Our clinic makes a topical hydrogel formula for topical treatment of acute acne
exacerbations that looks like, per oz:
1% Allantoin (300 mg)
3% Pentoxifylline (900 mg)

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0.025% Vitamin A (tretinoin, hydroxypinacolone, retinyl palmitate)

(7.5 mg)(usually 8,333 ius/ml)
10 drops Lemon Essential oil
in an Aloe based hydrogel,
Apply to skin lesions and irritated skin 1-2 times per day.
Impetigo contagiosa is strongly associated with group A hemolytic Strep in
children under 5 and usually manifests as a thick, sticky, honey-colored crust over ulcers.
Bullous impetigo is caused by Staph. aureus and presents with thin, varnish-like crusts. It
resembles ringworm in that it heals centrally while spreading peripherally. Effective
treatment requires dramatically changing the terrain at the site and reducing the bacterial
load. An antibacterial soap (my personal favorite is Dr. Bronner’s Lavender Castille
soap) to wash the area three times a day, followed by an antibacterial rinse, a strong
decoction of Hydrastis, Mahonia or Berberis usually works well. Unpasteurized honey
can be placed directly on the lesion with a cover; the sugar in the honey has a desiccating
effect on the bacteria and presents some anti-microbial action of its own. These lesions
usually resolve within 5-7 days without complication. When there is complication, one
can have scarring, especially on the face that will usually resolve after several months7.
Cellulitis is a common bacterial skin infection, with over 14 million cases
occurring in the United States annually. It accounts for approximately 3.7 billion dollars
in ambulatory care costs and 650000 hospitalizations annually. It is usually attributed to
the same bacteria as impetigo, that is, Group A beta-hemolytic Strep, Staph aureus and
other gram negative bacteria8. The streptococci produce streptokinase, DNAse, and
hyaluronidase each of which digests a component of the cellular architecture of the body
that would normally keep the infection contained to that area. This condition usually
requires some break in the skin, scratching or other trauma, in order for the bacteria to be
able to descend deep enough into the tissue to cause cellulitis. Increased susceptibility to
this condition is recognized in alcoholics, patients with nephrotic edema, stasis
dermatitis, lymphedema and malnutrition. Erysipelas is a type of cellulitis also related to
Streptococcal bacteria. It was previously most commonly seen in infants, young children
and the elderly and often after upper respiratory infection. Now, we also see it quite often
in young adults with piercings of the head and face. The manifestation of cellulitis begins
with redness, swelling, heat and tenderness, occasionally there will be blistering or an
infiltrated surface that looks like the skin of an orange. It is an acute bacterial infection
causing inflammation of the deep dermis and surrounding subcutaneous tissue. The
infection is without an abscess or purulent discharge. Treatment should be more
aggressive than that for impetigo; Veratrum viride tincture as an external treatment is
suggested by Ellingwood in his American Materia Medica, Therapeutics and
Pharmacognosy9. I have had opportunity to use it with good effect as the moistening
agent in a warming compress applied directly to the infected area. Internally, a tincture of
Echinacea (4 parts), Mahonia (3 parts), Phytolacca (2 parts), and Baptisia (1 part) can be
quite effective in resolving this situation, especially when used in tandem with alternating
hot/cold application to the area. Sunlight is essential and drawing poultices made from
ground flax, bentonite clay or slippery elm can also be helpful. It is imperative that the

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patient work to resolve those issues that caused them to have an increased susceptibility
to this condition. Patients who are immunocompromised, colonized with methicillin-
resistant Staphylococcus aureus, bitten by animals, or have comorbidities such as
diabetes mellitus may become infected with other bacteria. If the clinician correctly
identifies and promptly treats cellulitis, it typically resolves with appropriate
antimicrobial approaches, delayed treatment allows more microbial opportunists time to
add to the colony, antimicrobial resistance is a horizontally shared trait in bacteria, that is,
the genes for resistance are spread across different species, within the same generation,
the magic handshake. The more traffic you get through a wound, the more likely you are
to develop antimicrobial resistance. The other option for inheritance is vertical, you got
that trait from your parents or grandparents and you will likely pass it on to your
grandchildren.
Fungal infections range from superficial infections like the Tineas (ringworm,
athlete’s foot, jock itch) to systemic infections like Candida or Aspergillus,
dermatophytes are the most common pathogenic filamentous fungi, with an infection rate
of as high as 20%-25% worldwide. They generally infect the nails, skin, and hair and
commonly manifest as tinea capitis, onychomycosis, tinea corporis, and tinea pedis.
Dermatophytes may also invade the dermal tissue and even deep organs, particularly in
immunocompromised patients with congenital or acquired immunodeficiency, and these
infections can progress to life-threatening conditions. There are three basic types of
dermatophytes depending on host preferences and ecological niches: anthropophilic
dermatophytes are primarily transmitted from person to person and usually result in
chronic infections with moderate clinical symptoms; zoophilic dermatophytes prefer
selective animal hosts but can normally infect other species, including humans, often
causing inflammatory skin infections; and geophilic dermatophytes survive on
keratinized waste present in the soil and are rarely pathogenic but can produce more
severe inflammation than anthropophilic species. Trichophyton rubrum is among the
most frequently detected species globally and is responsible for 50%-90% of
dermatophytoses. There are several genera of fungi that cause Tinea infections; they are
all more and less susceptible to the measures that we will discuss here. These fungi all
create a keratolytic enzyme, causing scaling of the skin, crumbling nails and breaking
hair. They create filae, hair-like projections like a mycelium in the skin that cause
vesicles and redness; many people develop an allergic response, which causes an
additional output of histamine in the area and incredible, voluptuous itching. Diagnosis
can be made by scraping the infected area, applying potassium hydroxide and visualizing
the spores and hyphae under a microscope10. This condition is one of the reasons why the
modern health care practitioner really needs to have microscope in their office. Treatment
varies based on the location involved; this is a situation where radical shifts in the
biological terrain are essential. Shifting the pH of the climate around the feet by putting
baking soda in one’s shoes is a simple and effective measure for athlete’s foot. Fungal
infections of the nail beds are particularly long-lived infections, partly because the nails
grow so slowly, but also because there is often not a great deal of blood flow to the ends
of the body. I have found that a solution of 5% thyme oil in ethanol is very effective for

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nail fungus of the hands and feet, it requires a twice a day application for up to two
months, sometimes adding 2% DMSO makes it work a little quicker. For skin
manifestations I find that a beeswax and olive oil salve with oregano and thyme oils
added at the rate of 5 mls of each per two ounces of salve works fairly well. I have seen
Tea tree oil work intermittently well for most skin fungi. Many times a fungal infection
of the scalp will manifest as dandruff and responds pretty well to Aveda’s Rosemary
Essence shampoo into which is added Rosemary essential oil to make a 1% combination
(5 ml in 500 ml), I have also had good results with Paul Mitchell’s Tea Tree Oil Shampoo
and Conditioner. An astringent rinse administered after shampooing helps control itching
at least for a few hours, I recommend a diluted solution of 10% Glyco-thymuline (Alka-
thyme and Alkalol work at least as well) mouthwash in water (these are 100 plus year old
products that are essential oils in various alkaline solutions-promoted as mouthwashes
and nasal rinses). Alternating hot and cold application in the shower can be helpful to
encourage blood flow into and out of the scalp area. Internally, an alterative combination
with diaphoretic properties can make a significant difference in the duration of the
infection. A combination of Achillea (15 ml), Phytolacca (15 ml), Tilia (15 ml), Stillingia
(10 ml), and Zanthoxylum (5 ml) dosed at 60 drops twice a day for a month to six weeks
is pretty helpful.
Viral diseases of the skin include warts and most of the rash diseases of childhood.
Warts are fairly straightforward and seem to have a strong association with the psyche.
Sometimes the practitioner can “purchase” the warts of their younger patients, giving
them a dollar for each wart usually makes the wart disappear in 1-2 weeks.
Psychotherapy, homeopathy and constitutional botanical prescribing: including a lengthy
interview is usually successful in adult patients. Topical interventions like 25%
Podophyllum in alcohol, Thuja oil, salicylic acid, liquid nitrogen and surgical removal
can be construed as superficial and suppressive, some level of internal treatment with
agents that enhance host anti-viral defenses may be more ideal, consider botanical 'anti-
viral' agents like Lomatium, Hypericum, Glycyrrhiza, vitamin A and Melissa. This
concept of an herbal antiviral can get complicated-these are not necessarily items that kill
viruses in a petri-dish--nor in the far more complicated living organism. The plant and its
constituents stimulate a wide range of host defenses that include some responses to viral
organisms that might lead to their eradication, or their assimilation into the micro-
ecology of the body, as the case may be.
An in-depth discussion of the rash diseases of childhood would have to include a
discussion of vaccinations, as much as I personally would love to forge into such a
controversial realm, it goes beyond the scope of this discussion. Just know that, vaccines
are like any other product, some of what is in the marketplace is well-made and
accomplishes its stated objective, and other products are not as good...discernment
doesn't make one an "anti-vaxxer" any more than lack of discernment makes one a "good
citizen". There are governmental regulatory processes in place to ensure a consistent and
safe supply of product deemed essential to the public's health and well-being. Your
confidence in those processes may be proportionate to your confidence in your political
leaders and the choices that they make on your behalf. It may be worth your time

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exploring that industry before we engage in rhetorical shouting matches, because there is
a lot of ignorance being pushed forward by both sides of the discussion.
A viral rash (also known as an exanthem) is an eruptive skin rash that is related to
a viral infection, they most commonly occur in childhood and include chickenpox
(varicella), fifth disease, measles (rubeola), roseola, and rubella (German measles). Over
the past 7 decades, improved public health measures have dramatically decreased the
number of cases of these conditions and it is easy to forget that each of the viral rashes
have a distinct pattern of emergence, which is an aid in diagnosis11.
Chickenpox, caused by the Varicella-zoster (VZV) virus, is a highly infectious
disease, usually associated with childhood with around 4,000,000 cases diagnosed every
year. By the time they reach adulthood, more than 95 percent of Americans have had
chickenpox. Transmission occurs from person-to-person by direct contact or through the
air. Chickenpox most commonly occurs in children between the ages of 5 and 9. In the
US, in areas with a large number of children in daycare settings, chicken pox in children
between the ages of 1 and 4 is more common12.
Since 1995, a chickenpox vaccine has been available for children 12 months of
age and older. The Center for Disease Control & Prevention’s Advisory Committee on
Immunization Practices, the American Academy of Pediatrics, and the American
Academy of Family Physicians recommend that all children be vaccinated with the
chickenpox vaccine between 12 and 18 months of age with a booster vaccination between
11 and 12 years of age. The UK reviewed the cost effectiveness of the vaccine and
initially decided that it was not worth the expense. Their stated rationale is that if
chickenpox in children disappears as a result of a vaccine program, adults would no
longer have their immunity boosted by exposure to their chickenpox-suffering children
and grandchildren and would be more likely to get shingles, which would cost more than
complications from chicken pox13. It was not deemed cost-effective for the NHS to
immunize children against chickenpox until November of 2023, when the vaccine was
finally approved in the UK. Another situation where just because we can, doesn't mean
we should...and, of course, the economic argument wins, always interesting when that
happens in healthcare.
Symptoms are usually mild among children, but may be life threatening to infants,
adults, and people with impaired immune systems:
• Fatigue and irritability one to two days before the rash begins
• Itchy rash on the trunk, face, under the armpits, on the upper arms and legs, and
inside the mouth
• Fever/Malaise
• Decreased appetite
• Muscle and/or joint pain
• Cough or runny nose
Chickenpox has an incubation period of 10 to 21 days after exposure, it is
contagious for one to two days before the appearance of the rash and until the blisters
have dried and become scabs, which usually happens within 4 to 5 days of the onset of

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the rash. Children should stay home and away from other children until all of the blisters
have scabbed over. Family members who have never had chickenpox have a 90 percent
chance of becoming infected when another family member in the household is infected.

First Disease-Measles
The first detailed description describing measles was published in 910 by Rhazes
(860–932), who was chief physician at the hospital in Baghdad. According to his book al-
Judari wa al-Hasbah (Treatise on Smallpox and Measles), measles is a disease caused by
too much bilious blood. He states that even an experienced physician may have difficulty
distinguishing smallpox from measles, both diseases are eruptive fevers but, smallpox is
much more severe and leaves indelible skin scars on survivors, while the measles rash
does not cause ulceration and disappears by peeling. Rhazes' treatise was translated into
Latin by Gerard of Cremona in the 13th century when measles was referred to by the
Latin word morbilli (''little disease'', derived from morbus). In the 11th-12th centuries,
several measles epidemics were reported in Europe and it is generally accepted that the
disease was widespread in Europe and in South and East Asia, India and China all
through the Middle Ages. In England and Scotland, measles epidemics were reported in
the 17th century in 1670 and 1674, both of which were documented by the Englishman
Thomas Sydenham (1624–1690), in a chapter entitled 'On the Measles', in his Complete
Works published in 1693. He coined the term measles from the medieval
English mesles and the Latin misella (diminutive of misery). His work differentiated
measles from scarlet fever and smallpox. The disease persisted in an endemic state
without interruption in Great Britain and Europe throughout the 18th century and even
increased during the 19th and 20th centuries. In 1896, the American physician Henry
Koplik (1858–1927) described a pathognomonic sign of measles, "Koplik's spots" which
are bluish-white spots in a patchy pattern on the buccal mucosa, which present a few days
before the skin rash manifests14.
The general course of the infection begins after a 14 day incubation period, the
disease begins with a 2–4 day invasion phase, and a progressive fever that can reach 40
°C, with general malaise and headaches. Patients often suffer with rhinitis, a runny nose,
cough, and conjunctivitis that causes watery eyes. Köplik's sign is detectable in 70% of
cases. The disease may be accompanied by diarrhea, abdominal pain and vomiting. More
rarely, convulsions or a meningeal syndrome can be observed. A maculopapular rash
appears, with little pruritus, formed by large irregular and confluent plaques. The rash
begins on the face and neck and spreads in a single outbreak over 3–4 days to the entire
body, including the palms of the hands and soles of the feet. While the fever subsides in
3–4 days, the rash sheds before disappearing. Patients are contagious 2–3 days before the
invasion phase and remain contagious for 10 days15.

Second Disease-Scarlet Fever

Scarlet fever is not caused by a virus but by the bacteria Streptococcus pyogenes
(Group A Streptococcus) which causes a syndrome characterized by a blanching,
erythematous, maculopapular rash often described as "sandpaper-like," a "strawberry

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tongue," and exudative pharyngitis. The causative organism is a gram-positive bacterium

adapted to humans that grows in pairs and chains and is responsible for a range of
infections, including superficial, deep, and invasive conditions such as cellulitis,
pharyngitis, erysipelas, and necrotizing fasciitis. Group A Strep produce streptococcal
pyrogenic exotoxins (SPEs), which act as superantigens and are exceptionally potent
activators of T cells, they are the primary cause of the erythematous rash associated with
scarlet fever16.
Scarlet fever epidemics were common in the 19th century and while the
prevalence of scarlet fever declined in the 20th century, a resurgence of Group A Strep
infections occurred in the 1980s, and now, more virulent epidemic strains have emerged,
leading to an increase in scarlet fever cases. Notable complications can arise from Group
A Strep infections, including rheumatic heart disease and poststreptococcal
glomerulonephritis. Prompt treatment of acute infections is essential to prevent these
complications.

Third Disease-Rubella-German measles, Three-day measles-

Rubella virus is an enveloped, positive-stranded RNA virus classified as a
Rubivirus in the Matonaviridae family, its average incubation period is 17 days, with a
range of 12 to 23 days. People infected with rubella are most contagious when the rash is
erupting, but they can be contagious from 7 days before to 7 days after the rash appears.
Rubella is transmitted primarily through direct or droplet contact from nasopharyngeal
secretions, humans are the only natural hosts, and in temperate climates, infections
usually occur during late winter and early spring. Rubella is characterized by a mild,
maculopapular rash along with lymphadenopathy, and a slight fever, 1/4-1/2 of infections
are asymptomatic17.
The skin rash:
Usually starts on the face
Becomes generalized within 24 hours
Lasts an average of 3 days
Occurs in 50% to 80% of people infected with rubella
The Lymphadenopathy:
May precede rash
Often involves posterior auricular or suboccipital lymph nodes
Can be generalized
Lasts between 5 and 8 days
It is considered a relatively mild condition that can lead to complications and death
and include thrombocytopenic purpura and encephalitis.
Arthralgia or arthritis may occur in up to 70% of adult women with rubella.
When rubella infection occurs during pregnancy, especially during the first trimester,
serious consequences can result. These include:
Miscarriages/Fetal deaths/stillbirths
Severe birth defects known as Congenital Rubella Syndrome (CRS), a condition
that affects a developing baby in the womb when the mother is infected with the

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rubella virus. CRS can affect almost everything in the developing baby's body and
cause complications such as:
Deafness
Cataracts
Heart defects
Intellectual disabilities
Liver and spleen damage
Low birth weight
Skin rash at birth
Glaucoma
Brain damage
Thyroid and other hormone problems
Inflammation of the lungs
Although Rubella has been eradicated from the US as of 2004, international exposure
still manifested in 15 babies born last year with CRS.

Fourth disease--Duke's Disease

This controversial disease, also not a virus, was described by Clement Dukes in
1900 and was what we now refer to as staphylococcal scalded skin syndrome (SSSS
or Ritter's disease). This disease is caused by epidermolytic (exfoliative) toxin-
producing strains of Staphylococcus aureus. The term was dropped from medical
textbooks in the 1960's. SSSS is usually see in infants and begins with an abrupt
appearance of perioral erythema that is well-demarcate and tender to the touch, a rash
covers most of the body in around 2 days. Applying slight pressure with side-to-side
movement of a finger to the skin lesions results in displacement of the epidermis from
the dermis (positive Nikolsky's sign). In most cases the lesions become fluid filled
bullae or cutaneous blisters. The fluid in the bullae and blisters is clear and does not
contain bacteria or white blood cells. The bullae and blisters will break and will then
desquamate. The lesions do not always fill with fluid and in this case some refer to the
disease as staphylococcal scarlet fever. Desquamation of lesions also occurs with
staphylococcal scarlet fever. Within 7-10 days of lesion appearance the skin heals
without any scarring. Secondary bacterial infections of the lesions can result in
scarring18.

Fifth Disease-Erythema infectiosum

Fifth disease is a common viral exanthem caused by parvovirus B19, a non-
enveloped, single-stranded DNA virus, that is commonly seen in children between
five and fifteen years old, in the spring and summer months. It is one of the six most
common viral rashes in children and can also affect adults. Route of transmission is
primarily via droplets from respiratory secretions, although it can also be spread
through blood. Pruritus, low-grade fever, malaise, and sore throat precede the rash in
approximately 10% of cases, lymphadenopathy is not generally present, and adults
may complain of joint pain. Facial erythema ("slapped cheek") that consists of red

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papules on the cheeks that rapidly coalesce in hours, forming red, slightly edematous,
warm, plaques that are symmetric on both cheeks but do not cover the nasolabial fold
and the circumoral region. The "slapped cheek'' appearance fades in 4 days. Lace or
net patterned rash is a unique characteristic eruption that begins on the extremities
approximately 2 days after the onset of facial erythema and extends to the trunk and
buttocks, fading in 6 to 14 days. At times, the rash (exanthem) begins with a blanket
of redness and does not become characteristic until irregular clearing begins to take
place. The eruptions may fade and then reappear in previously affected sites on the
face and body during the next 2 to 3 weeks (recurrent phase). Extreme temperature
changes, emotional upsets, and excess sunlight may stimulate recurrences. The rash
fades without scaling or pigmentation and there may be a slight lymphocytosis or
eosinophilia on complete blood count19.

Sixth Disease-Roseola infantum

Roseola infantum is a common disease of childhood caused by a primary infection
with human herpesvirus 6 (HHV-6) and human herpesvirus 7 (HHV-7). This disease,
also known as exanthema subitum, presents in children between the ages of 6-12
months with 90% of cases occurring in children younger than two years. Caused by
the B variant of HHV-6, patients with the virus classically present with an acute onset
of a high-grade fever,104 F, for three to five days. The child will experience a rapid
reduction (breaking) of the fever with an accompanying nonpruritic, pink papular rash
that begins on the trunk. It is found all over the world and is considered to be the
cause of 10% to 45% of febrile illness in infants. Due to the high fever and the ability
of the virus to cross the blood-brain barrier, 15% of children will also experience an
acute febrile seizure. HHV-6 will likely remain latent in immunocompetent patients
but can be a major cause of morbidity and mortality in patients who are
immunosuppressed. Primary symptoms include malaise, conjunctivitis, orbital edema,
inflammation of the tympanic membranes, lymphadenopathy, irritability, anorexia, a
bulging fontanelle, diarrhea, cough and other upper respiratory tract symptoms.
Uvulo-palatoglossal spots also referred to as Nagayama spots, are erythematous
papules found on the soft palate and uvula that are seen in two-thirds of patients20.
The fever typically breaks after three to five days and small, rose-pink to red,
maculopapular rash develops with numerous 2-5mm lesions. A pale halo can occur
around the macules and papules in some cases. The rash usually begins on the trunk
and can spread to the neck, extremities, and face, it is typically nonpruritic, blanching
and persists from one to two days.

It is important for any health care practitioner to be able to differentiate between

these fairly common illnesses. For the most part, they are illnesses that are benign when
allowed to run their course naturally. Effective management of fever is probably the most
critical for parents. It is useful to remember that your immune system works best at a
body temperature of 102-103 degrees. Herbal teas are wonderful in this instance; yarrow,
ginger and eupatorium can be sweetened with honey or stevia for kids. Their diaphoretic

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action helps dissipate excess heat from the body. EmergenC packets by the Alacer
Company (there are a dozen equivalent brands) make pretty good “Popsicles” rich with
minerals, which prevent dehydration. Most febrile seizures are more related to
dehydration and electrolyte imbalances rather than simple increases in body temperature.
Hydrotherapy measures are usually the most effective for children of all ages. A wet
sheet pack can turn the tide of even the most frightening febrile conditions and involves
preparing a damp sheet, spread onto a dry warm blanket, preferably wool, and placed on
a bed. Place the child in a warm to hot bath (fevers less than 101.5, use a hotter bath,
fevers above 101.5, use a more tepid bath) for at least ten minutes. The patient can be
drinking herbal tea, you can place oils and salts in the bath, or they can just play in the
water, when you take them out of the bath wrap them up snugly in the wet sheet and the
blanket, being sure to tuck the blanket in firmly around the neck and feet. Most children
will go to sleep like this, leave them at least 15 minutes, the longer the better, if you can
keep them there for several hours, the result will be more dramatic. Measles, Covid and
RSV involve some immunosuppression that increases risk for secondary infections.
Some potentially relevant part of discussing infectious processes is a discussion on
the basic functions of the immune system, that part of the immune system that is specific
and learned. The cellular component of this part of the immune response is the
lymphocyte; immunoglobulins make up the soluble component (floating around in your
bloodstream and congregating in tissues). Lymphocytes are divided into three subsets,
those derived from the thymus gland (T cells), those derived from the bone marrow (B
cells) and natural killer cells (NK cells). T cells are responsible for cell-mediated
immunity while the B cells are responsible for humoral immunity (antibodies, cytokines).
NK cells are associated with the major histocompatibility complex system of the body;
they determine what is self and what is non-self and help to eradicate neoplastic and
foreign tissue. All of the lymphocytes can be found in the lymphatic tissues of the body,
this includes the spleen, the intestinal mucosa, and the bone marrow as well as the
peripheral lymphatic vessels and nodes. The lymphocytes have a preformed structure and
an anticipatory strategy for the immune system. There are at least a million different
types of preformed B cells and equally as many preformed T cells. Each different type of
preformed lymphocyte has a particular affinity for different families of invading
organisms.
When a specific antigen is presented to these elements of the specific immune
response they begin to form antibodies to that substance. These antibodies are simply
immunoglobulins with a specific affinity for that antigen. Immunoglobulins make up
about 20% of plasma proteins and they are separated into 5 classes; IgM is the first
antibody formed after initial exposure to an antigen, IgG is the most prevalent antibody in
the blood, and is produced after IgM levels decline and serves to maintain the immunity
that IgM began. IgA is an antibody that is secreted to the surface of the body through
mucus membranes (saliva, tears, respiratory, intestinal, genitourinary tracts and
colostrum) where it provides an early antibacterial and antiviral defense. IgD is important
in the development and growth of B cells and serves to further alert the system about
what it should be attacking and what should be left alone. IgE, like IgA, is found in the

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mucosal secretions of the body. It is found in very low concentrations in the blood and
higher concentrations in the tissues. IgE levels are elevated in patients with atopic
conditions like eczema and other allergies. All types of antibodies bind vigorously to
their antigen and contribute to their destruction directly or indirectly through initiation of
the complement cascade.
Immunoglobulins have a fundamental structure shaped like a “Y” consisting of a
constant portion, the stem of the Y and halfway up the arms, and a variable portion at the
ends of the arms. The constant portion of the antibody always and forever recognizes
certain classes of antigens, whereas the variable portion accommodates the diversity of
substances within the class of antigens. It is the variable portion that binds to the
antigenic substance because it is allowed to vary its structure in ways to that make a more
exact fit to the antigen. In the case of IgE, the variable portion is closely related to mast
cells and basophils. When an antigen is bound to IgE, it causes the membrane of the mast
cell or basophil to rupture, releasing histamine, leukotrienes, eosinophil chemotactic
substances, protease, heparin and platelet activating factors. These agents work together
to cause a dilation of the local blood vessels, attraction of eosinophils and neutrophils,
increased permeability of the capillaries and loss of fluid into the tissues, damage to the
local tissues, and contraction of the local smooth muscle cells. These are the cellular
elements that create the symptoms of allergy. Urticaria and eczema occur when this
process is triggered in the skin and is unable to be shut down again because the cascade
of events carries with it too much momentum.
Urticaria or hives refers to a solid edema of the skin related to a hypersensitivity
that may be confined to one small area of the body or could include the entire body.
Urticaria is classified as anaphylaxis if several organ systems are involved, especially the
structures around the throat. In acute urticaria, a precipitating agent can usually be
uncovered by interviewing the patient: a new medication, a different food, an infection
(bacterial, viral, fungal, or parasitic), or a change in environment. Chronic stress seems to
play a substantial role in the etiology of most of these cases. Essentially, some antigen is
presented; IgE is created to deal with that antigen and mast cells and basophils are
destabilized and torn up as the antigen antibody complex comes across the membrane.
This will account for an acute, first episode of urticaria. Chronic urticaria becomes a type
of learned response on the part of the body, that is, the system survived the previous
onslaught(s) by utilizing this strategy, and so it continues to employ it. Chronic urticaria
loses its dependence on IgE and can be triggered by a multitude of agents. Treatment
involves initially elimination of the offending agent, if known, and stabilizing mast cells
so that they are less likely to blow off histamine, over time a tolerance can develop.
Conventional medical treatment employs antihistamines and steroids, these are agents
that suppress the bodies desire to rid itself of a potential invader and usually the body will
resume its process when those agents are gone21. Botanically derived flavonoids can play
a major role in decreasing the fragility of mast cells and basophils, by making the
membranes of these structures more stable, requiring a greater amount of stimulation to
cause them to destabilize and release their histamine soup. We have enjoyed a measure of
success with a powder made from equal parts Amalaki fruit (Emblica officinalis), Gambir

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(Uncaria gambir), turmeric (Curcuma longa), and Licorice (Glycyrrhiza glabra) dosed at
1 tsp. 3-4 times a day with patients suffering from chronic urticaria with fairly good
results. The trick with a lot of these patients is keeping them from becoming sensitive to
the agents that we are employing in order to help them resolve the condition. This process
requires great flexibility on the part of the practitioner and is not always amenable to pre-
packaged products. I encourage these patients to increase their consumption of colorful
fruits and berries, especially darker berries and yellow/orange fruits and vegetables. Fish
oil can be immensely helpful, I recommend at least a gram, three times a day. An
elimination/rotation diet is critical for these patients and a diet/exposure diary can be
most enlightening for uncovering offending agents in the environment. I have found that
in some desperate cases, the tricyclic antidepressant Doxepin, will help them sleep, and
provides stability to the mast cells and often can change the course of chronic urticaria
within a few days. I use a very small dose, 5 mg before bed--where a usual adult dose
might be 25-50 mg.
A skin rash is dermatitis, literally "inflammation of the skin" which can manifest
from contact with an irritant or allergen, contact dermatitis, or from some other
sensitivity happening in the system that is manifesting with skin symptoms, termed atopic
dermatitis.
Contact dermatitis tends to be an itchy and inflamed skin disease, generally caused by an
inflammatory response to contact with some ingredient or object that a person is either
allergic to or that is irritating to the skin. Contact dermatitis can occur anywhere on the
body that comes in contact with allergens or irritants, including hands, feet, scalp, face,
arms, legs, chest, abdomen and genitals. In the case of irritant dermatitis, the goal of
therapy is to remove the irritant and soothe the skin. Irritants may damage normal skin or
worsen an existing dermatitis. Weak irritants may include soaps, detergents, acetone and
even water, strong irritants include acids, alkalis, phenol and other chemical exposures, it
can take weeks or months of exposure to a weak irritant before symptoms manifest, it
could take a single very brief exposure to a strong irritant to initiate symptoms. Washing
the irritant away and the use of clay or charcoal drawing poultices can be very effective
for these types of dermatitis. Treatment involves removing the irritant and triaging the
wound, in the case of straightforward contact dermatitis--consider a battery acid burn, or
some soap left to dry behind your ear. I recommend Dr. Bronner’s aloe castille baby soap
for washing and a comfrey goo or flaxseed meal poultice placed on the area to soothe it.
These types of dermatitis will generally resolve within 5-7 days. Irritant contact
dermatitis is more closely related to direct chemical injury to the epidermis which
happens when skin cells are damaged by exposure to irritating substances, like soaps, hair
dye, and chemical solvents. The immune system is activated, whether the ingredient
causes an allergy or not is somewhat irrelevant and is related to the quality of the skin
barrier. You can even develop contact dermatitis from things you’ve been in contact with
for years or your entire life, repeated exposure of compromised membranes to irritants,
tends to produce allergy mediated responses to those irritants so that later, minor
exposure creates much more severe symptomatology.

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Seborrheic dermatitis is an example of a contact dermatitis that has some allergic

potential in that it is the oily secretions that often exacerbate the condition, the rash
usually develops on the scalp, armpits or pubic hair. On darker skin tones, the rash often
looks pink, slightly purple, or lighter than the surrounding skin. People with lighter skin
tones tend to have a red, raised rash. Dandruff may be considered a milder form of
seborrheic dermatitis. The two conditions are similar in that they both cause white-to-
yellowish scales and flakes, which may be dry itchy or greasy and itchy. Sometimes, both
dandruff and seborrheic dermatitis can be treated the same way. Dandruff confines itself
to the scalp where seborrheic dermatitis can appear anywhere on the body, it is also more
inflammatory than dandruff, with more swelling and discoloration. When a baby has
seborrheic dermatitis, it usually appears on the scalp and is called cradle cap. Babies can
also develop seborrheic dermatitis in other areas like the folds of their skin, chest, back,
or diaper area. No matter where seborrheic dermatitis appears on a baby’s body, it’s
usually still called cradle cap.
Allergic contact dermatitis specifically arises from an allergic immune reaction
that can be immediate or it can be delayed by a day or two. When allergic contact
dermatitis manifests, the skin becomes hyper-responsive to the presence of the
irritant/allergen, so while we still get potential irritant damage, we also get local release
of pro-inflammatory mediators, degranulation of mast cells releasing histamines and
locally active proteolytic enzymes which create additional tissue destruction. Topically
applied agents should be well strategized as the reactive membrane tends to acquire new
things to become allergically sensitive to as they are slathered on the compromised field.
Treatment of allergic contact dermatitis requires uncovering the offender, avoiding such
and soothing the skin as mentioned above. Baking soda and Epsom salt baths can be very
effective for the allergic component as they have a strong alkalinizing effect that
neutralizes residual histamines in the skin, increase in peripheral circulation helps
eliminate remaining allergens.

Allergens and irritants that cause contact dermatitis are constantly changing with
new agents being pronounced every year that cause contact dermatitis, especially in
cosmetics and personal care products. For the last several decades, both the North
American Contact Dermatitis Group and the American Contact Dermatitis Society have
named an “allergen of the year” to help both healthcare providers and the general public
understand what products contain the featured ingredients and how to avoid them.
Here are some of the most common allergens that lead to contact dermatitis:

Metals, such as nickel, gold and cobalt

Medicines like neomycin and glucocorticoids
Fragrance mixes such as myroxylon pereirae (balsam of Peru), commercial fragrance
mixes
Rubber and latex products, such as gloves and balloons
Preservatives like formaldehyde and parabens

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Personal care products containing the chemical methylchloroisothiazolinone or

methylisothiazolinone
Borax, which can be used to make a “slime” toy for children
Lanolin from sheep, which can be found in lotions and clothing
Plants like henna or poison ivy
Hair dyes

A systematic review of scientific literature on toys that cause contact dermatitis identified
several common offenders, including electronics (video game controllers), toy cars,
costume jewelry, bicycles, slime and children’s clay. The most common ingredient
causing contact dermatitis in children is nickel which can be an allergen for both children
and adults and is often found in toys and electronic devices like cell phones, iPads and
computers.
Eczema is derived from the Greek word meaning “to boil over” an apt description
of the presentation of most cases of eczema. Eczematous dermatitis has many different
forms, it can be related to contact with foreign material (this can be allergic or irritant), it
can be atopic, seborrheic, exfoliative, nummular or dishydrotic. This is by no means a
comprehensive list but shows that there are numerous manifestations of this complex
condition. Atopic dermatitis is the most common manifestation of eczema, and, for many,
it becomes a chronic, recurrent skin condition. It is the skin manifestation of allergic
tendency and is closely related to asthma and hay fever. There are many different
predisposing factors for an individual to develop atopic dermatitis, not the least of which
is heredity. There is a documented abnormality of cyclic nucleotide function in these
patients where cAMP levels are reduced due to higher levels of cAMP phosphodiesterase
activity and lack of prostaglandin precursors. This results in excessive histamine release
and diminished immune function. Elevated serum IgE levels and decreased IgA levels are
also present in these patients22.
Atopic dermatitis is the most common form of eczema and affects people of all
ages, it causes dry, itchy and inflamed skin. It's common in young children but can occur
at any age. Atopic dermatitis is long lasting (chronic) and tends to flare at times, often
related to stress. It can be irritating but it's not contagious. Moisturizing regularly and
following other skin care habits can relieve itching and prevent new outbreaks. The vast
majority of atopic eczema patients that I see have a chronic condition which originated in
their bowel and is manifesting on the skin as a type IV hypersensitivity reaction.
Typically, the lining of the bowel has been compromised, either from infection, chronic
stress, use of NSAIDS, or abuse of irritant laxatives. Over time the patient develops small
patches of eczema which eventually get larger, prompting the patient to seek some sort of
treatment. Once the mucus membrane of the bowel becomes compromised, it is only a
matter of time before the permeability of bowel becomes altered due to inflammation.
Larger particles of relatively undigested food are allowed to pass across this membrane;
they become perceived as foreign invaders/allergens and become covered in IgE
antibodies on their way through. The presence of the IgE antibodies causes a wide scale
disruption of mast cell membranes, allowing the release of histamine soup and more

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tissue damage ensues. Some percentage of the circulating antibody-antigen complexes is

able to reach the systemic circulation and will cause destabilization of mast cells and
histamine release wherever they might end up, the surfaces of the body are the usual
sites, skin, lungs and sinuses.
Treatment begins with reconditioning the bowel lining, soothing and protecting it
while avoiding known allergens. A rotation/elimination diet can be very effective with
increased intake of high flavonoid containing foods, yellow and orange fruits and
vegetables and dark berries. Licorice tincture, powder or pills can be helpful in
minimizing inflammation in the bowel itself. The amino acid glutamine is the principal
fuel for small intestine enterocytes and epithelial tissue. It is the most abundant amino
acid in the bloodstream and is considered a "conditionally essential" amino acid, as there
are times where demand cannot be met by mobilization from other tissue stores. The
lungs and skeletal muscle are the major producers of circulating glutamine, and the
intestinal tract is the primary user, accounting for as much as 40% of total glutamine
uptake by the entire body. Glutamine supplementation has been shown to increase the
height of intestinal villi and mucosal thickness, as well as increasing secretory IgA
secretion. I usually start a patient on 5 grams 3-4 times a day and work up to 15 grams
twice a day. A digestive enzyme taken with meals can be helpful in reducing the size of
the food that is being passed across the intestinal membrane and will often reduce
symptoms accordingly. The addition of soluble fiber like flaxseed meal or oat bran is also
very soothing to the intestinal membrane and has a normalizing effect on the bacteria that
live there. Quercetin chalcone and Hesperidin methyl chalcone as water soluble
flavonoids are helpful to improve the integrity of the mast cell membranes. Diamine
oxidase, usually derived from legumes like the sugar snap pea (Pisum Sativum) and
lentils (Lens culinaris), and also made in our kidneys, liver and small intestine, is one of
the major enzymes involved in the metabolism of histamine...it is often very helpful in
reducing excessive levels histamine in the body--it is dose in units and 200,000 units 3-4
times a day is usually a decent starting point. Cromolyn sodium, ultimately derived from
the Ayurvedic herb Ammi visnaga, is a topical mast cell stabilizer that has an effect for
about six hours and is useful to prevent release of histamine when some offender enters
the system. We purchase this material as a bulk powder and reconstitute it ourselves to
2% solution and dosed at 5 ml or 100 mg three times a day, prior to meals.
The use of comfrey goo topically on the eczematous areas can be very helpful. Put
chopped comfrey root and a small amount of water in a blender, blend until well mixed
and apply the goo to the area. Cover with flannel or bandage material and leave on
overnight, by morning the rash is generally quite a lot better. Alterative, lymph-moving
tinctures are excellent forms of intervention and can often be curative. Blue flag (Iris
versicolor) 10 drops three times a day can be used as a lymphatic alterative to help
restore proper lymphocytic response to food allergens. The idea is to increase IgM and
IgG antibodies in the serum over IgE antibodies.
Occasionally a patient will present who has either had long-term steroid therapy or
has such an adrenal insufficiency that steroid intervention might seem necessary (very
fatigued, very inflamed patients form whom no intervention seems to be making a

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difference). This topic is a hotbed of philosophical controversy. I find that the

pharmaceutical steroidal preparations are very heavy handed and do not allow reasonable
recovery of adrenal function for the patients that they are used on, this is even true when
these patients are tapered off of these agents. My favorite alternative is a ‘Licort’ cortisol
tincture, I produce this in my office by adding 30 grams of micronized cortisol acetate to
1000 ml of a 1:1 fluid extract of Glycyrrhiza glabra, this produces a tincture that contains
1 mg of cortisol per drop. According to Dr. Jeffries, the author of the text, “Safe Uses of
Cortisol”, the average daily equivalent of cortisol output for most people is 25-30 mg.
When a patient is given more than this quantity it can be too suppressive and disruptive
of normal physiology. This is not to say that some people aren’t able to produce
quantities of cortisol that are far above this level, just that from a supplementation basis,
we may not want to risk suppression or disruption in our interventions. I have found that
replacing an existing steroid regimen with an equivalent dosage of licort makes it far
easier to wean the patient down later, with very little to no ill effects after
discontinuation. For those patients who seem to need some kind of cortisolic
augmentation, I will add the cortisol tincture to their existing botanical preparation and
dose it 5 drops 4 times a day. I find that it mixes quite well with any preparation that also
contains licorice, for all of the reasons that we discuss when we talk about licorice.
There is evidence that atopic and contact dermatitis can coexist and that patients
with the atopic form may even be more sensitive to allergens and irritants that cause local
contact dermatitis. The current thought among researchers is that active atopic disease —
with inflamed skin and a compromised skin barrier — can result in an increased
possibility that allergens and irritants will trigger even more inflammation. When both
are present, treatment for either can be less effective because the patient may
continuously be exposed to factors that cause rashes associated with contact dermatitis.
The number one goal for preventing and treating contact dermatitis symptoms is to avoid
contact with the culprit agent (or irritant).
I really appreciate the simple efficacy of hydrogels for dermatitis. A hydrogel is
any swellable network of polymers that exhibit 3-dimensional, hydrophilic, insoluble
structures composed of crosslinked polymeric chains that attract aqueous solutions
without disintegration23. Hydrogels are the slippery slimy components widely present in
plants like Aloe, Ulmus, Comfrey and Astragalus and can be synthesized from natural or
synthetic polymers. Functioning as a physical barrier, hydrogels provide protection for
the wound bed against external contamination while creating a moist environment that
facilitates wound repair. Most hydrogels are immunologically inert, and their high water
content provides topical cooling and soothing effects, making them particularly suitable
for burn wound dressings. Aloe vera is probably the most universally applied hydrogels
for contact dermatitis--it seems to make intuitive sense to put a cooling soothing gel on a
red and inflamed section of skin. We make an aloe/hyaluronic acid hydrogel for different
manifestations of dermatitis that consists of 10 mg/ml hyaluronic acid in distilled water
mixed into a gel and then mixed 50/50 in an aloe gel, for chronic conditions, I find that
the addition of ceramides (3%) and glycyrrhizinate (also a gel former) at 1 mg/ml are
often very helpful in a topical application. Pilocarpus jaborandi, 4 drops 3 times a day,

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acts as a diaphoretic, helping to promote expulsion of metabolic debris through the skin
and increasing IgA secretion to the surfaces of the body; yarrow, eupatorium and ginger
can be used similarly. Coleus forskohlii can also be employed as an agent that helps
promote cAMP over cGMP in the body and can be very helpful in resolving acute
eczema attacks. Liver function is extremely important in promoting cAMP production,
the classic liver tonifying herbs like Arctium, Taraxacum, Trifolium and Melilotus can be
very helpful in this regard.
Psoriasis is a chronic, proliferative and inflammatory condition of the skin that is
characterized by pinkish-red plaques covered with silvery scales, particularly over the
extensor surfaces of the body, the scalp, and the lumbosacral area, also affecting the
joints (psoriatic arthritis). There are several subtypes, with the "plaque type" being the
most common (85-90% of cases) with pinkish-red plaques with white silvery scales
presenting on the trunk, extremities, and scalp24. Removal of the psoriatic scales creates
pinpoint bleeding called the 'Auspitz sign' and can be used to confirm the diagnosis. The
pathophysiology of psoriasis involves infiltration of the skin by activated T cells which
stimulate the proliferation of keratinocytes. This dysregulation in keratinocyte turnover
allows layers of skin to build on one another resulting in the formation of the thick
plaques, inflammation produces epidermal hyperplasia (increased production of skin
cells) which fail to secrete adequate amounts of lipids, resulting in the flaky and scaly
skin that is typical of psoriasis. Conventional topical therapy involves the use of
emollients and moisturizers to improve barrier function and retain the hydration of the
stratum corneum. Topical agents that have found clinical use include coal tar, dithranol,
corticosteroids, vitamin A and D analogs. Because there is an autoimmune element to the
manifestation of psoriasis, immuno-suppressants are often used for short-term
management and include methotrexate, cyclosporine and fumarates. Biologicals are
manufactured proteins (cytokine inhibitors, monoclonal antibodies) that interrupt the
immune process in psoriasis and include infliximab, adalimumab, etanercept, and
interleukin antagonists. The language leaves clues, anything that ends in the suffix -mab,
is a monoclonal antibody. Before starting any biological agent, the patient should be
worked up for tuberculosis and hepatitis. There is a serious risk of infections in these
patients and all precautions should be taken that the patient is not severely
immunocompromised.
Psoralen is the parent compound in a family of naturally occurring organic
compounds known as the linear furanocoumarins, structurally related to coumarin by the
addition of a fused furan ring, and is considered as a derivative of umbelliferone.
Psoralen occurs naturally in Ficus carica (fig) (the most abundant source of psoralens),
they are also found in smaller quantities in Ammi visnaga, Pastinaca sativa (parsnip),
Petroselinum crispum (parsley), Levisticum officinale (lovage), Foeniculum vulgare
(fennel seeds), Daucus carota (carrot), Psoralea corylifolia (babchi), Apium graveolens
(celery), and essential oil of Citrus bergamia (bergamot oil). Psoralen is a mutagen, it
intercalates into DNA (replaces hydrogens in the nucleoside bases) and on exposure to
ultraviolet radiation (UVA) can form interstrand cross-links (ICL) with thymine, which
inducing apoptosis. Psoralen plus exposure to UVA is called PUVA therapy, and is used

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to treat hyperproliferative skin disorders like psoriasis and skin cancer, and PUVA
treatment itself leads to a higher risk of skin cancer. Phototherapy includes PUVA
therapy as well as NBUVB (Narrowband UVB light) with a range of 311 nanometers to
313 nanometers. NBUVB is equally effective without the side effects of psoralen like
gastrointestinal upset, cataract formation, and carcinogenic effects. It can safely be given
to children, pregnant and lactating females, and even older patients. Patients with
psoriasis should avoid all skin trauma for fear of inducing a Koebner reaction, new
psoriasis plaques at sites of injury. In addition, psoriatic patients should avoid the use of
beta-blockers, chloroquine, or NSAIDs and alcohol because of the risk of developing
fatty liver.
A number of studies have explored the efficacy of dietary fish oils as a safe
therapy for various skin conditions due to their anti-inflammatory, anti-chemotactic and
moisturizing properties. Inhibition of inflammation helps to improve the barrier function
of the skin, induces stratum corneum maturation and differentiation, inhibits
proinflammatory eicosanoids, improves lamellar body formation, contributes to cytokine
suppression, and lipoxygenase inhibition25. 1000 mgs of a good quality omega 3 fatty
acid three times a day is a good starting place.
The vitamin D system is historically well known for its role intracellular calcium
and bone metabolism, more recent evidence over the past 20 years has shown a wide
variety of biological activities for vitamin D, including cell differentiation, control over
cellular development, immunomodulation, and regulation of many other hormonal
systems. Deficiency has become more and more prevalent, or we are looking more
frequently at those levels and maybe they were always on the low side for some
locations. Dietary sources are classically animal products like cod liver oil, salmon, tuna,
beef, eggs, and chicken breast, as well as milk, yogurt, butter and cheese (especially
cheddar), and some mushrooms contain vitamin D2. The epidermal skin cells are unique
in that they synthesize vitamin D and possess the enzymatic mechanism to convert it into
its active form, calcitriol (1,25(OH). Vitamin D has an effect on both B and T cells, as
well as the adaptive immune response by altering B-cell activity, limiting differentiation
and proliferation and inducing apoptosis, it also causes a modulation of immunoglobulin
production, including autoantibodies. Vitamin D affects T-cell activity by inhibiting T
helper (Th) cell proliferation, as well as supporting a transition from a pro-inflammatory
into a more tolerant immunological condition through several mechanisms, including
inhibition of the cytokine production required for Th17 and Th1 differentiation,
encouraging T cells to release IL-10, which is an anti-inflammatory Th2 cytokine, it also
decreases the intensity of class II molecules of the main histocompatibility complex that
affect dendritic cells. These impacts on keratinocyte development and proliferation are
central to vitamin D's function in the treatment of psoriasis. Dosage is 800-2400 ius/day
of cholecalciferol and subject to testing blood levels.
Vitamin E is a powerful lipid-soluble antioxidant found in all cell membranes that
exists in eight forms in nature, generally as mixes of tocopherols and tocotrienols, the
tocopherols are the most physiologically active, the tocotrienols play a significant
supportive role, it is important that we utilize a mix of tocopherols and tocotrienols as D-

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alpha-tocopherol is inherently unstable by itself, and, D,L-alpha tocopherol shouldn't be

eaten at all. Patients with psoriasis tend to a statistically significant decrease in vitamin E
plasma levels when compared to their peers, and those with the most severe presentation
had the lowest vitamin E levels, which also correlated with the highest alcohol
consumption. Psoriasis, alopecia areata, and vitiligo patients generally have lower tissue
and blood vitamin E concentrations than healthy controls. Our clinic finds tha a
combination of vitamin E (mixes of tocopherols and tocotrienols--AC Grace Co and Life
Extension make decent products), selenomethionine, and coenzyme Q10 is very helpful
for people with psoriasis and psoriatic arthritis.
Aloe barbadensis is one of our best and oldest first-aid interventions for superficial
wounds and burns, it belongs to the Liliaceae family, and has a long history of use
worldwide in traditional medicine. References to the medicinal use of the Aloe plant date
back 4000 years, with the first inscriptions mentioning the plant found on Sumerian clay
tablets from 2100 BC. The Egyptian Ebers Papyrus of 1552 BC also mentions therapeutic
uses of the plant, including internal use as a laxative. According to Greek legend, in 333
BC, Aristotle advised Alexander the Great to capture the island of Socotra in the Indian
Ocean for its famous Aloe vera plantations, which would be of great help in treating his
wounded soldiers. Aloe leaf gel began to be industrialized and commercialized in the
1950s, and the global Aloe market size is projected to grow from $2.65 billion in 2023 to
$4.55 billion by 2030. Aloe vera is a plant that is often cultivated in people’s homes
throughout the world as a natural compound intended for widespread use by both adults
and children and recognized in clinical practice as a dependable tool for wound healing.
It is universally associated with the treatment of skin injuries such as cuts, burns,
frostbite, radiation, and electrical injuries and a large part of the reason why Aloe gel is
able to be helpful is due to its physical properties as a hydrogel. Acemannan and Aloe-
emodin are antibacterial active ingredients that have been shown to reduce the severity of
redness and scaling in patients with psoriasis. Aloe vera has shown immunomodulatory,
antioxidant, anti-inflammatory, anti-fungal, and anti-tumor properties, it provides
hydration to the skin increases collagen activity. Several studies have shown aloe extracts
to be as effective as topical steroids in patients with psoriasis, with virtually no side
effects.
Mahonia aquifolium, Oregon grape, is an evergreen shrub in the Berberidaceae
family, it is indigenous to the United States and has a long history of being employed to
treat a variety of inflammatory skin conditions. Berberine, as an extracted alkaloid, has
been demonstrated to have anti-inflammatory effects in the body which include the
downregulation of lipoxygenase enzymes, protection from lipid peroxidation, inhibition
of T cells infiltration into psoriatic lesions, a decrease in cyclooxygenase activity, a
reduction in IL-8 and prostaglandin E2. Berberine modulates rapid and uncontrolled cell
reproduction by intercalating (replacing hydrogen) into DNA, preventing replication of
DNA and cell proliferation. Other alkaloids present in Mahonia also inhibit lipoxygenase,
such as oxyberberine, jatrorrhizine, corytuberine, and columbamine and contribute to
anti-inflammatory action)26. A 10% Mahonia aquifolium hydroethanolic extract has been
shown to suppress IL-8, IL-1, T cells, TNF-alpha, and TNF-beta, each of which plays a

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significant role in the progression of psoriasis. We use it internally as well as topically (it
does tend to make things (everything) yellow), most of our other berberine plants are
interchangeable, depending on your region. Here in the southwest, we are more likely to
use Algerita root (Mahonia trifoliata), Kofa's barbery (Berberis harrisonia), or red
barberry (Berberis haemotocarpa).
Psoriasis is a complex metabolic condition, our approach with patients is to
encourage a dramatic reduction in their simple sugar intake--in fact, taking total
carbohydrate intake down to 50 grams or less can seem practically miraculous in some
patients. Focusing on anti-inflammatory fats and avoiding hydrogenated oils and fried
foods also makes a huge difference for many people. Ensuring adequate sleep and regular
nutrition, tending towards a less is more approach and pulling families of foods out of the
diet for a month to 6 weeks at a time can be a helpful calibration for how certain foods
may be influencing our inflammatory processes. I have personally seen PUVA therapy
work for people, while loading them with agents to hopefully prevent skin cancer later
on. Topical salves (beeswax and macadamia nut oil) with 5-6% salicylic acid can be very
helpful for the reduction of the superficial scaling, a 10% saffron hydrogel (10 mg/ml
hyaluronic acid in saffron water decoction) with an added 3% ceramides (Ceramide x-
blend) is often very very helpful once the scaling has been removed, we have them apply
it 2-3 times a day.

References for surface eruptions

1. O'Neill AM, Gallo RL. Host-microbiome interactions and recent progress into
understanding the biology of acne vulgaris. Microbiome. 2018 Oct 02;6(1):177.
2. Cassidenti, D. L., Paulson, R. J., Serafini, P., Stanczyk, F. Z., & Lobo, R. A. (1991).
Effects of sex steroids on skin 5 alpha-reductase activity in vitro. Obstetrics and
gynecology, 78(1), 103–107.
3. Agak GW, Kao S, Ouyang K, Qin M, Moon D, Butt A, Kim J. Phenotype and
Antimicrobial Activity of Th17 Cells Induced by Propionibacterium acnes Strains
Associated with Healthy and Acne Skin. J Invest Dermatol. 2018 Feb;138(2):316-
324.
4. Fitz-Gibbon S, Tomida S, Chiu BH, Nguyen L, Du C, Liu M, Elashoff D, Erfe MC,
Loncaric A, Kim J, Modlin RL, Miller JF, Sodergren E, Craft N, Weinstock GM, Li
H. Propionibacterium acnes strain populations in the human skin microbiome
5. Saeidnia S, Manayi A, Gohari AR, Abdollahi M. The story of beta-sitosterol-a review.
European J Med Plants. 2014;4(5):590–609.
6. Zaenglein AL. Topical retinoids in the treatment of acne vulgaris. Semin Cutan Med
Surg. 2008 Sep;27(3):177-82.
7. May PJ, Tong SYC, Steer AC, Currie BJ, Andrews RM, Carapetis JR, Bowen AC.
Treatment, prevention and public health management of impetigo, scabies, crusted
scabies and fungal skin infections in endemic populations: a systematic
review. Trop Med Int Health. 2019 Mar;24(3):280-293.

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8. Cranendonk DR, Lavrijsen APM, Prins JM, Wiersinga WJ. Cellulitis: current insights
into pathophysiology and clinical management. Neth J Med. 2017 Nov;75(9):366-378.
9. Ellingwood, Finley, MD. 1919. American Materia Medica, Therapeutics, and
Pharmacognosy, Reprinted by Eclectic Medical Publications, Sandy, OR, 1998.
10. Deng R, Wang X, Li R. Dermatophyte infection: from fungal pathogenicity to host
immune responses. Front Immunol. 2023 Nov 2;14:1285887.
11. Goldust M. Viral Diseases in Dermatology. Viruses. 2023 Feb13;15(2):513.
12. Bakker KM, Martinez-Bakker ME, Helm B, Stevenson TJ. Digital epidemiology
reveals global childhood disease seasonality and the effects of immunization. Proc
Natl Acad Sci U S A. 2016 Jun 14;113(24):6689-94.
13. Freer G, Pistello M. Varicella-zoster virus infection: natural history, clinical
manifestations, immunity and current and future vaccination strategies. New
Microbiol. 2018 Apr;41(2):95-105.
14. Patrick Berche, History of measles, La Presse Médicale, Volume 51, Issue 3,
2022,104149, ISSN 0755-4982.
(https://www.sciencedirect.com/science/article/pii/S0755498222000422)
15. Perry RT and Halsey NA. The Clinical Significance of Measles: A Review. J Infect
Dis. 2004 May 1;189(Supplement 1):S4–16.
16. Walker MJ, Brouwer S. Scarlet fever makes a comeback. Lancet Infect Dis. 2018
Feb;18(2):128-129.
17. Lambert N, Strebel P, Orenstein W, Icenogle J, Poland GA. Rubella. Lancet. 2015
Jun 06;385(9984):2297-307.
18. Nguyen QD, Vu MN, Hebert AA. Recognizing and Managing Staphylococcal
Scalded Skin Syndrome in the Emergency Department. Pediatr Emerg Care. 2022
Mar 01;38(3):133-135.
19. Rogo LD, Mokhtari-Azad T, Kabir MH, Rezaei F. Human parvovirus B19: a review.
Acta Virol. 2014;58(3):199-213.
20. Tesini BL, Epstein LG, Caserta MT. Clinical impact of primary infection with
roseoloviruses. Curr Opin Virol. 2014 Dec;9:91-6.
21. Wedi B, Raap U, Kapp A. Chronic urticaria and infections. Curr Opin Allergy Clin
Immunol. 2004 Oct;4(5):387-96.
22. Kantor R, Thyssen JP, Paller AS, Silverberg JI. Atopic dermatitis, atopic eczema, or
eczema? A systematic review, meta-analysis, and recommendation for uniform
use of 'atopic dermatitis'. Allergy. 2016 Oct;71(10):1480-5.
23. Yao Y, Zhang A, Yuan C, et al. (2021). Recent trends on burn wound care: Hydrogel
dressings and scaffolds. Biomater Sci 9:4523–40.
24. Gamret AC, Price A, Fertig RM, Lev-Tov H, Nichols AJ. Complementary and
Alternative Medicine Therapies for Psoriasis: A Systematic Review. JAMA Dermatol.
2018 Nov 01;154(11):1330-1337.
25. Ricketts JR, Rothe MJ, Grant-kels JM. Nutrition and psoriasis. Clin Dermatol.
2010;28(6):615–626.
26. Wiesenauer M, Lootke R (1996) Mahonia aquifolium in patients with Psoriasis
vulgaris—an intraindividual study, vol 3, no 3, pp 231–235.

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SWINGING THE PENDULUM- WHAT IS

COMPOUNDING?
ACID-BASE CHEMISTRY FOR
HERBALISTS COMPOUNDING WAS THE ART AND SCIENCE
OF PREPARING PERSONALIZED MEDICATIONS
DR. KENNETH PROEFROCK FOR PATIENTS.

“MADE FROM SCRATCH” – INDIVIDUAL

INGREDIENTS MIXED TOGETHER IN THE EXACT
STRENGTH AND DOSAGE FORM FOR THE
PRESENTING PATIENT ANDTHEIR CONDITION
MEDICINE IS A CONTEXT SPECIFIC ENDEAVOR
THAT IS NOT CONDUCIVE TO A ‘ONE SIZE FITS
ALL’ APPROACH.

MASS PRODUCED PRODUCTS ARE THE

BLUNTEST INSTRUMENTS TO APPLY TO A
HEALTH CONDITION—

THE COMPOUNDER NATUROPATHIC MEDICINE

NEARLY ALL PRESCRIPTIONS WERE
MAINTAINED THE ABILITY TO COMPOUND IN THEIR LICENSURES.
COMPOUNDED PRIOR THE ADVENT OF
• CERTIFICATE TO DISPENSE
MASS DRUG MANUFACTURING IN THE
1950S AND ’60S. THE PHYSICIAN’S HERBAL MEDICINE, ONE OF THE PILLARS OF NATUROPATHIC TRADITIONAL
AND THE PHARMACIST’S ROLE AS A PRACTICE, INVOLVES THE MIXING OF BOTANICAL TEAS, POWDERS AND
TINCTURES.
PREPARER OF MEDICATIONS QUICKLY
CHANGED TO THAT OF A DISPENSER PART OF THAT TRADITION ALSO OFTEN INCLUDED THE IN OFFICE
OF MANUFACTURED DOSAGE FORMS, COMPOUNDING OF A MULTITUDE OF SUPPLEMENTAL AMINO ACID,
VITAMIN, MINERAL AND CONCENTRATED FOOD POWDERS, THE
AND MOST MEDICAL PRACTITIONERS
DISPENSING OF NUTRACEUTICALS AND THE INTRAVENOUS
WERE NO LONGER TRAINED TO ADMINISTRATION OF NUTRITIONALLY ORIENTED FLUIDS.
COMPOUND MEDICATIONS.
THE “ONE-SIZE-FITS-ALL” NATURE OF
MANY MASS-PRODUCED MEDICATIONS
MEANT THAT SOME PATIENTS’ NEEDS
WERE NOT BEING MET.

TYPES OF COMPOUNDING
• POWDERS/CAPSULES (BOTANICAL AGENTS, EXTRACTS, AMINO ACIDS,
DOCUMENTATION
NUTRACEUTICALS, NUTRITIONAL SUPPORT)
IF IT ISN’T WRITTEN DOWN, IT DIDN’T HAPPEN.
• TINCTURES (BOTANICAL EXTRACTS, HOMEOPATHIC MOTHER)
IF IT ISN’T WRITTEN DOWN CORRECTLY, IT STILL DIDN’T HAPPEN—BUT YOU ARE LIABLE
• CREAMS/GELS/SALVES
• OPHTHALMIC PREPARATIONS (EYEDROPS, EYEWASHES)
DOCUMENTATION SHOULD BE SIMPLE, UNAMBIGUOUS, EASY TO READ DOCUMENTS
• NASAL SPRAY/IRRIGATION SHOULD BE KEPT UP-TO-DATE
• NEBULIZER SOLUTIONS DO YOU HAVE:
• INJECTABLES (IM/SQ/IV) 1. CORRECT FORM
2. CORRECT INFORMATION ON FORM
3. FORM IS COMPLETE
4. INFORMATION IS LEGIBLE AND READILY ACCESSIBLE
5. DEMONSTRATES CONFORMITY: ZEROGAP BETWEEN ACTUAL
PERFORMANCE AND ESTABLISHED POLICY
Sumerian pharmacy tablet 3500 BCE

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BASIC COMMON SENSE IDEAS

WEAR CLEAN CLOTHING—DON PROTECTIVE APPAREL TO PREVENT
CONTAMINATION

PRACTICE GOOD SANITATION—IF YOU ARE SICK OR HAVE OPEN WOUNDS,

MAYBE YOU SHOULDN’T BE INVOLVED IN THE MAKING OF PEOPLE’S
MEDICINES RIGHT NOW.

DON’T PICK YOUR NOSE OR YOUR EARS AND THEN HANDLE PRODUCT

YOUR PHONE IS A VECTOR OF CONTAMINATION

DOCUMENT EVERYTHING!!
H2O àOH- + H+
Neutral pH Alkaline Acid

The pH scale is the standard measure of acidity

and was developed by the head of the Carlsberg
brewery laboratory’s chemical department in
1909. Dr. Soren Sorenson (1868-1939) devised
the scale while doing pioneering research into
proteins, amino acids and enzymes. The meaning of
pH is ‘power of hydrogen’ and the scale provides a
simple measurement for the exact amount of
hydrogen ions are in a solution.

Pure H2O at 25.00 C has a concentration of H+ ions

that is 10 -7M. This places pure water at a 7 on the
pH scale—coffee is about a 5, so the hydrogen ion

HClàCl- + H+ concentration is 10-5 or 0.0001M

Because it involves the “decimal logarithm of the
reciprocal of the hydrogen ion concentration” those
NaOHàNa+ + OH- solutions between 0-6 are acidic, and have the
highest H+ concentration and those from 8-14 are
alkaline.

ACETIC ACID
ACIDS
Acetobacter spp. are the main agents of ethanol oxidation into acetic acid in wines, they
are common in sour rotten grapes, which may increase acetic acid level in grape juices
Many fruits contain acids, especially unripe fruit,
which creates the sour taste. Most early acids were to values higher than 1 g/L of acetic acid. Acetobacter aceti and Acetobacter
products of fermentation, dairy products like sour pasteurianus are the most common species recovered from wines. The final outcome is
cream and yogurt are rendered more acidic than the wine acetification by accumulation of acetic acid which, together with ethyl acetate,
milk/cream they are made from as the fermenting
organisms create lactic acid as a product of their leads to the ‘vinegar’ taint. Because of their aerobic nature, the main preventive measure
metabolism. Fermentation of fruits produce wine and is to avoid contact with air after wine fermentation---unless you want acetic acid.
grains produce beers/ales. Vinegar is a product of
both. Old wine became soured and people used that
sour wine as a condiment and preservative.

The word “Vinegar” is from a combination of two

Latin words—vin aigre, “sour wine.”

Wines and vinegars have been around since at least

6000 BC in Sumeria. Traces of vinegar have been
found in Egyptian urns from around 3000 BC.
Egyptian wall paintings contain many representations
of viticulture.

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Vinegars produced from various fermentations by acetic

VINEGAR acid bacteria are a traditional seasoning condiment used
all over the world. Various species of acetic acid bacteria,
which are mostly the bacteria that inhabit the ingredients, BOTANICAL TINCTURES
barrels, or pots, are found in vinegar fermentations along
with acetic acid. In these fermentation processes,
Acetobacter spp form a microbial biofilm community • Preserve an ages old system of creating
with other microbes. This community produces acetic hydro-ethanolic plant extracts.
acid, which contributes to preserving fermented foods
• In some cases, can be directly translated
and producing health-related elements, and is itself a
preservative. In Ancient Greece the mixture of water, into other solutions, hydrogels, nebulizers,
honey and vinegar was common and known as oxycrat, nasal and eye washes...strategies for
while in Rome the popular drink posca, the same removing alcohol and rendering osmolarity
condiment mixed with water, was considered a source of and pH into physiologically
strength. It was in Mesopotamia however, around 2,400 comfortable/useful ranges become
BCE, that vinegar became an essential means of important.
preserving food, allowing it to remain fresh for long
periods of time. This innovation gave rise to pickles and
pickling, a technique still used today to preserve
vegetables, meat and fish.

TROPANE ALKALOIDS
ALKALOIDS AND Tropane alkaloids (TA) are valuable secondary
ACETRACTS plant metabolites which are mostly found in high
concentrations in the Solanaceae and
Alkaloids are not a straightforward family of Erythroxylaceae families. The TAs, which are
compounds…there is no definitive difference between
alkaloids and other naturally occurring complex amines characterized by their unique bicyclic tropane
ring system, can be divided into three major
Generally, alkaloids are plant derived, tend to be groups: hyoscyamine and scopolamine, cocaine
alkaline in aqueous solutions (with exceptions) and
contain at least one N2- atom and calystegines. Although all TAs have the same
basic structure, they differ immensely in their
They tend to have a significant physiological effect on biological, chemical and pharmacological
the humans and animals who consume them.
properties. Scopolamine, also known as hyoscine,
Many alkaloids tend to form acetate salts when has the largest legitimate market as a
processed with vinegar, which renders them more water pharmacological agent due to its treatment of
soluble and amplifies their physiological effects.
nausea, vomiting, motion sickness, as well as
smooth muscle spasms while cocaine is the 2nd
most frequently consumed illicit drug globally.

Tropane alkaloids belong to the world’s oldest

plant medicines and their ATROPA BELLADONNA-
DEADLY NIGHTSHADE
ethnopharmacological applications include
analgesia, hallucinogens, and poisons. These Atropa belladonna, is named for Atropos, one of the three fates in Ancient Greek
mythology. This particular fate was responsible for cutting the thread of life. Her
ornithine-derived compounds comprise mono- second name has associations with the Italian goddess of battle Bellona.
, di-, and tri-esters, carboxylated and Consumption creates a light sensitivity and blurred vision (due to dilation of the
pupils), a sense of floating and spatial expansion beyond the body, drying of bodily
benzoylated tropanes. Several of these fluids and inability to urinate, altered heart rate, sweaty hands, and a sense of being
alkaloids occur as chiral structures due to the surrounded by the dead.

presence of a tropic acid residue attached to Contains the tropane alkaloids atropine, scopolamine, and hyoscyamine, which are
made in the roots of the plant and collect in the leaves and stems after harvesting the
the ecgonine nucleus as an ester. The former plant.
occurs naturally in its R-form, however, All parts of the plant contain tropane alkaloids. Roots have up to 1.3%, leaves 1.2%,
stems 0.65%, flowers 0.6%, ripe berries 0.7%, and seeds 0.4% tropane alkaloids;
racemic mixtures may appear, especially leaves reach maximal alkaloid content when the plant is budding and flowering,
during alkaline extraction (e.g., the formation roots are most potent at the end of the plant's vegetation period. Belladonna nectar is
transformed by bees into honey that also contains tropane alkaloids. The berries
of (+)-atropine from (–)-hyoscyamine). pose the greatest danger to children because they look attractive and have a
somewhat sweet taste, each berry can contain 2 mg of atropine. The root of the plant
is generally the most toxic part, though this can vary from one specimen to another

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BELLADONNA PREPARATIONS
Assuming 1.2-1.3% alkaloidal content in leaves and roots, with a
ACETRACTS AND OXYMELS OF NOTE
preponderance of the alkaloids in the form of L-Hyoscyamine
(87.6% in Leaves and 68.7% in roots), which converts into a less Lobelia acetract--antispasmodic
active, more stable racemic mixture of D,L-Hysocyamine. A standard
Corydalis acetract—pain relief
dilution for a tincture is 1:5 dilution of herb in solvent, which
produces a product that is 2.4-2.5 mg of alkaloid per ml of tincture. Datura acetract—antispasmodic
The solvent is usually a higher alcohol percentage, usually 65%, and
Fire Cider-in some of its incarnations
the addition of an acidic element like apple cider vinegar might help
keep the alkaloids in a free base form. Oxymel (from Latin 'acid and honey', from Ancient Greek oxys 'acid'
Assuming 30 drops per ml, each drop is 83 mcg of tropane and meli 'honey’) is a mixture of honey and vinegar (5:1 or so ratio),
alkaloids, 5 drops provides 415 mcg or 0.415 mg… used as a medicine. According to Scientific American, the mixture has
been used successfully against an antibiotic resistant biofilm and was
Most atropine eyedrops are 1% so they are 10 mg/ml, and one uses
1-2 drops at a time, which is 0.33 mg/drop. as much as 1,000 times more bacteriacidal than vinegar alone and as
much as 100,000 times more than honey alone.
GAWRYLEWSKI, ANDREA, SCIENTIFIC AMERICAN
5 drops of tincture is often our dose, and we might do that 3-4 times
a day in cases of gastrointestinal cramping, or to relax stiff muscles.
NEWSLETTER, OCTOBER 11, 2023
It seems to have some affinity for the GI tract and skeletal muscle.

Some characteristics of pectin:

Pectins Dissolves in water to give a colloidal solution,
which, when dehydrated, forms a solid gel.
Pectin is the primary component of all plants and makes up Dehydration may be brought about by 65%–70%
about two-thirds of the dry mass of plant cell walls where it sucrose; the pH range should be 3–3.5.
offers structural integrity, strength, and flexibility. Pectin is a
natural constituent of all omnivorous diets and is a significant Pectic acid has no gelling properties but calcium
source of dietary fiber. These oligosaccharides support pectate has the property of gelling in certain
useful microbiota in the gut and help lipid and fat conditions.
metabolism as well as glycemic regulation. Marketable
pectins are extracted from citrus peel and apple fruit, which When treated with hydrochloric acid, pectin is not
contain 20%–30% and 10%–15% pectin, respectively, precipitated from aqueous solution.
based on the dry mass. Pectin also comes from sunflower
heads, mango peel, soybean hull, passion fruit peel, sugar Excess calcium chloride solution does precipitate
beet pulp, Akebia trifoliata peel, peach pomace, banana calcium pectate.
peel, and even chickpea husk.
When an aqueous solution of pectin is made
Pectin is applied in various food products as a gelling agent, alkaline with sodium hydroxide and allowed to
thickener, texturizer, emulsifier, and stabilizer. Pectin grades stand for 15 min, the pectin is demethylated to
are based on the number of parts of sugar, which one part pectic acid.
of pectin will gel to an acceptable firmness under standard
conditions of pH 3.2–3.5, sugar 65%–70%, and pectin at When treated with lime (CaOH) water, a
the limits of 1.5%–2.0%. 100–500 grades of pectins are gelatinous precipitate will separate out after some
available in the market time.

ALKALINE AGENTS
Naturally occurring as mineral sources like limestone-CaCO3 to
CaOh—
Limestone is a sedimentary rock that is dominantly composed of the
calcium-bearing carbonate minerals calcite and dolomite. Calcite is
chemically calcium carbonate (CaCO3). Dolomite is chemically calcium-
magnesium carbonate (CaMg(CO3)2).
Snail and shellfish shells are also a source of calcium carbonate that,
when heated produces CaOH.
Lime (CaOH)—largely derived from heating limestone or shell debris

hardwood, seaweed and mineral rich plant ash—rich in hydroxides

and chlorides…potash, soda ash, sodium and potassium chlorides

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 2025 Medicines from the Earth Swinging the Pendulum - Proefrock

ARECA CATECHU/PIPER BETLE CULINARY ASH

BETEL QUIDS COLTSFOOT—TUSSILAGO FARFARA
JUNIPER-JUNIPERUS COMMUNIS
THE CHEWING OF BETEL NUT QUIDS DATES TO ANTIQUITY. HICKORY TWIGS-
IN THE 1ST CENTURY AD, SANSKRIT MEDICAL WRITINGS CLAIMED THAT
FOUR-WING SALTBUSH-ATRIPLEX
BETEL NUT POSSESSED 13 QUALITIES FOUND IN THE REGION OF CANESCENS
HEAVEN.
DESERT SALTBUSH ATRIPLEX POLYCARPA
IT IS PUNGENT, BITTER, SPICY, SWEET, SALTY, AND ASTRINGENT. IT WAS
SAID TO EXPEL WIND, KILL WORMS, REMOVE PHLEGM, SUBDUE BAD
ODORS, BEAUTIFY THE MOUTH, INDUCE PURIFICATION, AND KINDLE
PASSION.
Culinary ash—typically of
BECAUSE OF ITS CNS STIMULATING EFFECTS, BETEL NUT IS USED IN A Juniper wood, is burnt
MANNER SIMILAR TO THE WESTERN USE OF TOBACCO OR CAFFEINE.
completely free of carbon
ARECOLINE IS RESPONSIBLE FOR SOME OF THE EFFECTS OF BETEL QUID
CHEWING, SUCH AS ALERTNESS, INCREASED STAMINA, A SENSE OF material and sifted. It can
WELL-BEING, EUPHORIA, AND SALIVATION. be further cleaned up or
CHEWING THE NUT STIMULATES THE FLOW OF SALIVA TO AID used as a leavening agent,
DIGESTION. BETEL NUT ALSO HAS BEEN USED TO STIMULATE THE imparting a unique flavor to
APPETITE the food.

NIXTAMALIZATION
HOMEMADE LYE SOLUTION
The term nixtamal is an amalgam of the Nahuatl words nixtli (ashes) and tamali
(cooked maíz, or corn), and the technique has been practiced for thousands of
To make lye in the kitchen, boil the ashes from a
years in modern day Central America and Mexico. When milled, nixtamal hardwood fire (soft woods are too resinous and
becomes masa, the dough that forms tortillas, sopes, huaraches, tamales, and have less minerals) in a little soft water, rainwater
tlacoyos, among hundreds of other corn-based Mexican staples. is best, for about half an hour. Allow the ashes to
settle to the bottom of the pan and then skim the
On the East Coast of the United States, Native people traditionally ate liquid lye off the top. You can do this daily and
nixtamalized corn as a porridge and in stews; European settlers called it hominy, when you’ve got enough of the weak solution, boil
an anglicized version of the Powhatan (Algonquin) term rokahamĕn. the liquid down until it’ll float an egg. If the egg
sank, the concentration of lye in the solution was
Nixtamalized corn is a miracle food. The process changes the enzymatic too low, and it would be poured through the ashes
structure of corn; it intensifies the aroma and flavor. The kernels’ skin (or again in hopes of increasing the concentration. DO
pericarp) slips off, and the starches start to gelatinize. Critically, it also unlocks NOT use aluminum cookware it will eat them.
corn’s most beneficial nutrients: niacin, iron, protein, and dietary fiber.
You can make soap from this lye solution—you
can also use it as you would lye…

OPHTHALMIC
PREPARATIONS All Purpose Saline Eyedrop/Eyewash

Must be sterile (0.2 micron filter) A basic eye drop/eye wash can simply be 0.9% Saline…it can be made more
pH between 6-8—7.4 feels best for most soothing to dry and irritated eyes by adding a little sodium or potassium
bicarbonate. The basic recipe looks like 9 grams (2 level teaspoons) of sea salt in 1
Isotonic saline mostly… liter of water with 1.5 grams (1/4 tsp) of baking soda.
some therapeutic benefits to hypo and hyper and potassium-based products. For chronically dry eyes, consider adding a gelling agent or other thickener-
Allergy—mast cell stabilization 0.1% Hyaluronic acid (fills scratches and other depressions, holds moisture)
0.1% Glycyrrhizic acid (anti-viral, saponin to help lift away debris)
Cromolyn sodium/Quercetin chalcone
For viral infections of the eye, 2-3% L-Lysine (20-30 mg/ml) with glycyrrhizic acid
Infection—viral, bacterial, fungal
can be very helpful
Botanical extracts— Berberine sulfate, 0.1% or any strong Berberis spp water decoction will work, for
conjunctivitis and other bacterial infections of the eye.
berberine, Sarracenia,
Euphorbium Lysozymes are a wonderful addition that helps break down foreign debris in the
eye in chronic cases.
H2Ocean-saline/lysozymes

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 2025 Medicines from the Earth Swinging the Pendulum - Proefrock

GELS/HYDROGELS HYALURONIC
ACID

• Hydrogels can be made as Compounded Sterile Products (CSPs)

AN EXTREMELY COMMON POLYMER FOUND IN NATURE.
• Hyaluronic acid 5-7.5 mg/ml in distilled water can be made
MAKES UP AN ENORMOUS PROPORTION OF THE BASAL LAMINA OF MAMMALIAN
readily in the office on an as needed basis. TISSUES.
• More or less body can be added to the gel by adjusting the
hyaluronic acid content. A LINEAR POLYSACCHARIDE CONSISTING OF D-GLUCURONIC ACID AND N-
• Luer lock to luer lock adapters between two syringes makes an ACETYL-D-GLUCOSAMINE LINKED BY BETA(1,3) AND BETA(1,4) GLYCOSIDIC
LINKAGES.
ideal extrusion tool for making gels quickly and without a mess
• Our clinic uses a USP Sodium Hyaluronate powder, DISTINGUISHED FROM THE OTHER GLYCOSAMINOGLYCANS AS IT IS FREE FROM
we suspend 50-75 mg of powder in 10 ml DI water, COVALENT LINKS TO PROTEIN AND SULPHATE GROUPS.
extrude through a luer lock to luer lock adapter
between two 10 ml syringes and filter through a
HAS BEEN DEMONSTRATED TO BE IMPORTANT TO TISSUE FUNCTIONS SUCH AS
TISSUE HYDRATION, LUBRICATION, SOLUTE TRANSPORT, CELL MIGRATION, CELL
0.2 micron syringe filter prior to administration. FUNCTION AND DIFFERENTIATION.

GLYCYRRHIZIC ACID LYSOZYME--

MURAMIDASE
• A LYSOZYME IS A NATURALLY OCCURRING
ENZYME FOUND IN BODILY SECRETIONS SUCH AS
•
TEARS, SALIVA, AND MILK. IT FUNCTIONS AS AN
ANTIMICROBIAL AGENT BY CLEAVING THE
PEPTIDOGLYCAN COMPONENT OF BACTERIAL CELL
• WALLS, WHICH LEADS TO CELL DEATH.
• IN HUMANS, LYSOZYME MAY BE THE MEDIATOR
IN THE ANTI-TUMOR FUNCTION OF MACROPHAGES
WHICH, IT HAS BEEN SHOWN, SECRETE THE
• ENZYME.
• WE USE LYSOZYMES THAT ARE MADE FROM
CHICKEN EGG WHITE AND IT MAKES A NICE
•
ADDITION TO EYEDROPS FOR CONJUNCTIVITIS,
BLEPHARITIS OR DRY EYES.
• • CONCENTRATION IS 1% (10 MG/ML) IN A SALINE
BASE.

BERBERIS FREMONTII/MAHONIA Crocus sativa-Saffron

TRIFOLIATA/HAEMATOCARPA
Although cultivated since ancient times, the native habitat of this fall-blooming crocus is
ALGERITA unknown. It is commercially grown today in a number of locations, but primarily from
Spain to Italy to Greece to Iran to India, with almost 80% of world production coming
• Berberine containing plants, similarity in action but not the
from Spain and Iran.
same…
Each flower has three long style branches tipped with reddish-orange stigmas. The
• Generally, a bitter tonic for digestion, a stimulant for liver stigmas often protrude beyond the petal cup. It takes about 1/4 million stigmas
metabolism, topically antimicrobial.
(75,000 flowers) to produce one pound of saffron which in large part explains why
• Cold and astringent…long considered to be a helpful saffron is the most expensive spice regularly sold in commerce today. It is the one of
lymphagogue and anti-microbial agent in botanical medicine.
the richest natural sources of water-soluble carotenoids.
• Studies have confirmed an anti-proliferative effect of the root
extract on leukemic and psoriatic cell lines, inhibition of IL-8, Saffron is prescribed as a tea, 1-2 flower pistils in water twice a day, it can be added
modulating CD25 lymphocyte activation pathway, interleukin-10
signaling, and tumor necrosis-alpha secretion in human to other teas like green tea or bilberry tea. It makes a great base for eyedrops.
peripheral blood mononuclear cell (PBMC) subpopulations.
• Root extracts exhibit a moderate cytotoxicity and changes in
the signaling pathways linked to cell adhesion, proliferation,
migration, and apoptosis of tumor cells.
• Dried root tincture 1:5, dosed at 10-60 drops 3-4 time per
day…A strong decoction can be used as the base for
eyedrops/eyewashes

171
 2025 Medicines from the Earth Swinging the Pendulum - Proefrock

NANO-SIZED STRUCTURED STARCHES

Vitamin A Eyedrops
• CYCLODEXTRINS (2-HYDROXYPROPYL BETA-CYCLODEXTRIN)
We make an aqueous solution by complexing
• NON-TOXIC, DISSOLVABLE, STRUCTURED STARCH-
retinoic acid in cyclodextrin—
• POTATO AND/OR TAPIOCA DERIVED
0.25 mg of retinoic acid per ml of 45% 2-
hydroxypropyl beta-cyclodextrin will yield a • CREATES INCLUSION BODIES WITH FAT SOLUBLE MATERIALS IN AQUEOUS
MEDIA
final concentration of 8,333 ius/ml.

This material is added to a strong salinated

decoction of saffron—which consists of adding 1
gm of saffron pistils to 1 liter of 0.9% saline.

The eyedrops are a 50/50 mix of these two

solutions and typically dosed at 2-3 drops 2-3
times per day

2-hydroxypropyl beta-cyclodextrin EYEWASHES

(HPBCD)
• Eyewashes are a cornerstone of topical eye
Patented in 1983 for use as a
therapy, my personal favorite is an eyewash with
solubilizing agent—it nests fat soluble M. Malanga et al. / Journal of Pharmaceutical Sciences 105 (2016) 2921-2931 2923

succus of Cineraria maritima, Dusty Miller, 2-3

materials to render them more water
times/day. Cineraria has been shown to reduce
soluble.
and possibly reverse cataract formation, it acts to
stimulate profound movement of lymph through
Tapioca based structured starch
the eye. It produces a burning sensation and
made under alkaline conditions—
redness when washed into the eye.
Cyclodextrin chemistry-Solubilizes
more effectively at pH>10…we use
20% NaOH and 45% cyclodextrin. • For many years, the succus could be purchased
pre-made from Luytie’s Homeopathic Pharmacy
Then bring pH to desired 6-8 range in Missouri. Now we make it ourselves.
after complexation.

Cyclodextrins dissolve in hot water • Other eyewash materials that I have used with
much more rapidly than cold. more or less good effect include urine, rosewater,
and salinated teas of triphala, chamomile, and
Figure 1. Reaction scheme for HPBCD synthesis (a): low DS, (b): high DS.

chrysanthemum
used as eluent, and development time was typically 5 min. Visu- n-propanol:ethylacetate:H2O:NH4OH (25%) ¼ 6:1:3:1 (vol/vol/vol/
alization was performed by spraying the plate with a nebulized vol) were used as eluents. Development times were typically 15 and
solution of H2SO4 in ethanol and placing the TLC plate on a hot plate 20 min, respectively. Visualization was performed by spraying the
until charring was completed. plate with a nebulized solution of H2SO4 in ethanol and placing the
TLC plate on a hot plate until charring was completed.
TLC of HPBCD Samples
NMR Spectroscopy
The HPBCD sample was dissolved in methanol in 1% concen-
tration (wt/vol), and 2 mL of the solution was spotted on the The NMR spectra were recorded in D2O at 298 K (10 mg dis-
TLC plate; 1,4-Dioxane:NH4OH (25 %) ¼ 10:7 (vol/vol) and solved in 0.8 mL of deuterated solvent) on a 600 MHz Varian Inova

COLEUS FORSKOHLII
Figure 2. DEPT-ed HSQC spectrum of HPBCD (DS 5.9) with partial assignment (D2O, 298 K).

Coleus forskohlii is an aromatic herb growing all over India from

the Himalayas to Sri Lanka and Thailand and is probably in your
local home and garden store. It has a documented medical usage of
over 3,000 years, Sanskrit texts refer to it as "Makandi” and”
phashana bedi”
Forskolin (FSK) is a labdane diterpene that is obtained from the
tuberous roots of Coleus forskohlii, it is believed to be the plant’s
most active constituent. it has been used for centuries to promote
heart and lung health, it is still used to treat hypertension and
respiratory concerns such as asthma.
1% forskolin in saline at a dosage of 2 drops 3 times a day will
May have some impact on central nervous system cAMP
usually decrease intraocular pressure. In open angle glaucoma.
levels and mitochondrial activity…of interest in
Available as a bulk powder standardized to 20% forskolin, 200 inflammatory neurological conditions…PANS/PANDAS,
mg/gm, 1 gm of material will make 20 mls of eyedrop solution. seizure disorders.
Consider a 1% solution administered as a nasal spray.

172
 therapeutic agents. [Adv Drug Deliv Rev. 2012
the central nervous system (CNS), but unwanted side effects in the periphery. For such compounds,
See reviews..
traditional oral or intravenous drug delivery fails to provide benefit without cost. However, intranasal
See all..
delivery is emerging as a noninvasive option for delivering drugs to the CNS with minimal peripheral
2025 Medicines from the Earth exposure. Additionally, this method facilitates the delivery of large Swinging the Pendulum
and/or charged therapeutics, which fail - Proefrock
to effectively cross the blood-brain barrier (BBB). Thus, for a variety of growth factors, hormones, Cited by other articles in PMC
neuropeptides and therapeutics including insulin, oxytocin, orexin, and even stem cells, intranasal delivery Intranasal insulin and orexins to treat age-related cognitive decline

PILOCARPUS JABORANDI
is emerging as an efficient method of administration, and represents a promising therapeutic strategy for

NASAL SPRAYS/NASAL IRRIGATION

the treatment of diseases with CNS involvement, such as obesity, Alzheimer’s disease, Parkinson’s disease,
Huntington’s disease, depression, anxiety, autism spectrum disorders, seizures, drug addiction, eating
Neuro-Nano Interfaces: Utilizing Nano-Coatings and
[Advanced
Nanoparticles to Enable Next-Generation functional materials....
Electrophysiological
Recording, Neural Stimulation, and Biochemical Modulation
disorders, and stroke.
Jaborandi is the common name for Pilocarpus, which comes from the First-line management of canine status epilepticus at home and in
[BMCofVeterinary
hospital-opportunities and limitations the variousResearch. 2021
administration
KEY WORDS: central nervous system, insulin, intranasal administration, oxytocin, stem cells
Brazilian Tupi-Guarani language ya-mbor-endi, meaning “what routes of benzodiazepines
A Randomized Controlled Trial of Intranasal Neuropeptide Y in
[International Journal of Neuro...
Patients With Major Depressive Disorder
causes slobbering”. this plant is historically used for medicinal DIRECT INTRANASAL DELIVERY TO THE CENTRAL NERVOUS SYSTEM Go to:
(CNS): TARGETING WITH MINIMAL INVASIVENESS Probing the drug delivery strategies in ischemic stroke therapy
purposes, infusions of jaborandi leaves stimulate the production of [Drug Delivery. 2020
Traditionally, neurological disorders, like many bodily disorders, have been treated through peripheral
sweat and salivation, and they are applied in shamanic rituals for administration (predominantly oral administration). However, there are a variety of issues with using
See all..

peripheral administration to treat CNS diseases. Most significantly, it is difficult to impossible for many
fever treatment, stomatitis and as an antidote for poisons and toxins molecules, particularly large and/or charged ones, to enter the brain from the bloodstream due to the blood- Links
brain-barrier (BBB), which keeps foreign materials out (1). Additionally, first-pass metabolism can greatly MedGen
the imidazole alkaloid pilocarpine is found in the leaves of the plant reduce the bioavailability of any drug taken orally, to the point where only a small amount of active drug
PubMed
and acts as a cholinergic parasympathomimetic agent, stimulating actually reaches the circulatory system and ultimately the brain (2). Peripherally administered drugs can
also take a significant amount of time to reach the brain, so that in acute situations, such as seizures,
secretions in sweat, lachrymal and salivary glands. patients suffer and in some instances face other serious complications—including an increased chance of Recent Activity
mortality—while waiting for drug delivery. Plasma protein binding, another consequence of systemic Turn Off Clear
it has also been used to reduce xerostomia induced by head and neck administration, can also affect both the duration and intensity of a drug’s action, reducing its ability to Intranasal Treatment of Central Nervous System Dysfunction
efficiently cross the BBB (3). The final concern with systemic administration is the production of
radiation therapy and for the treatment of dry mouth associated with in Humans
unwanted, peripherally-induced side-effects. Compounds such as insulin, which have a variety of desirable Intranasal oxytocin administration is associated with
Sjogren's syndrome CNS effects, also induce dramatic systemic effects, which can in some cases be problematic (4). enhanced endogenous pain i...

As an alternative, intracerebroventricular injection can deliver drugs directly to the brain; however, it is See more..
It also contributes to hair growth when applied topically to the scalp highly invasive and therefore not realistic for clinical applications (5). On the other hand, intranasal
administration, especially to the upper portion of the nasal cavity, has been shown to achieve direct CNS
The raw powdered herb contains 1-3% pilocarpine—a 1% solution of delivery of a variety of compounds without invasiveness or major complications (6–9). In addition, it
pilocarpine is the desired strength causes rapid increases in CNS levels of these compounds, and for some—such as insulin—avoids any
significant peripheral uptake (10). It may thus represent the most promising, novel, non-invasive method
for delivering therapeutic substances directly to the CNS.

INTRANASAL MECHANISMS Go to:

A scheme illustrating the mechanism of nose-to-brain delivery is shown in Figure 1. While the mechanisms Review Intranasal delivery of biologics to the central nervous
system. [Adv Drug Deliv Rev. 2012]
involved in intranasal delivery of drugs to the brain are still being elucidated, some of the pathways
involved are known. For example, intranasal drugs have been shown to rapidly travel extracellularly along Delivery of insulin-like growth factor-I to the rat brain and spinal
cord along olfactory and trigeminal pathways [Neuroscience.
following 2004]

Nasal
the olfactory nerve pathways leading from the upper part of the nasal cavity directly to the brain
Intranasal delivery of insulin via the olfactory nerve pathway.
Highly vascularized
(6,9,11,12). This pathway is likely one of the largest contributors to intranasal drug delivery, as drug nasal mucosa and
NASAL
[J Pharm Pharmacol. 2012]
concentrations in the olfactory bulbs following intranasal delivery are among the highest in the CNS the olfactory tissue is in direct contact
(9,13,14). Administration with the central nervous system, allowing
See more ...

ADMINISTRATION OF rapid transportation into the

THERAPEUTIC AGENTS bloodstream & brain for therapeutic

agents, with onset of action near that of
IV administration.
The trigeminal nerve enters the brain
through both the pons and the cribriform
plate, which allows for delivery to both
For most nasal spray pumps the dispensed volume per actuation is 0.1 ml, and an administered
the anterior and posterior regions of the
volume of 0.1-0.2 ml per nostril is optimum in adults, more is prone to drip out immediately. brain. Transport of substances along the
Standard spray pumps will deposit most of the sprayed dose into the anterior region of the nasal olfactory and trigeminal nerve pathways
cavity. Surface tension of the droplets and mucus layer will cause the immediate spread of the can happen through both intracellular
and extracellular mechanisms. However,
spray and mucociliary clearance will distribute the liquid layer throughout the nasal cavity. Since
intracellular transport is a slow process,
the nasal mucus layer is continuously renewed and discarded into the throat, the nasal residence
Nasal administration is a straight shot to requiring at best several hours and at
time of the administered agent depends on how fast it dissolves within the mucus layer and worst several days. Extracellular
penetrates through the mucosa the brain
transport, on the other hand, is rapid and
likely accounts for much of the rapid
delivery and onset of action observed
with intranasal CNS therapeutics

Fig. 1

A scheme illustrating the mechanism of nose-to-brain delivery. Unlike the olfactory nerve which terminates in the Review Intranasal delivery of biologics to the central nervous
olfactory bulb, the trigeminal nerve enters the brain through both the pons and the cribriform plate, which allows system. [Adv Drug Deliv Rev. 2012]

for drug delivery to both the anterior and posterior regions of the brain (9,12). Transport of substances along the Intranasal delivery of insulin via the olfactory nerve pathway.
[J Pharm Pharmacol. 2012]
olfactory and trigeminal nerve pathways can happen through both intracellular and extracellular mechanisms (9).
However, intracellular transport is a slow process, requiring at best several hours and at worst several days Endocytic and exocytic pathways of the neuronal secretory
[J Comp
process and trans-synaptic transfer of wheat germ Neurol. 1985]
agglutinin-
(17,20). Extracellular transport, on the other hand, is rapid and likely accounts for much of the rapid delivery and
onset of action observed with intranasal CNS therapeutics (8,21). Abbreviations: ECS, extracellular space. See more ...

Jala Neti
A Basic Nasal Spray/Nasal Wash
The trigeminal nerve pathways are another conduit connecting the nasal passages to the CNS. Unlike the Review Intranasal delivery of biologics to the central nervous
system. [Adv Drug Deliv Rev. 2012]
olfactory nerve, the trigeminal nerve enters the brain through both the pons and the cribriform plate, which
allows for drug delivery to both the anterior and posterior regions of the brain (9,12). Researchers have Intranasal delivery of insulin via the olfactory nerve pathway.
Isotonic saline solutions at a neutral pH
demonstrated that a variety of intranasally delivered substances, including insulin-like growth factor 1 are the most comfortable..so, 0.9%
[J Pharm Pharmacol. 2012]

To perform jala neti, a neti pot is used with (IGF-1), interferon beta-1b and hypocretin-1saline can
(orexin A), beinmade
result bylevels
significant adding 9 grams
of radioactivity
Delivery of interferon-beta to the monkey nervous system
(two measured
in the teaspoons) to a liter
following intranasal administration. [Neuroscience. 2008]

a conical spout and is made of ceramic. The trigeminal nerve branches, trigeminal ganglion,of and
water. It isstrongly
the pons, worthsuggesting
notingthethat infectious
involvement of processes andmigratory
The rostral allergies streamcreate
plays a keyarole in intranasal
trigeminal nerves in intranasal delivery to themore
CNS (9,13,15). Additionally, in a recent experiment in mice,
acidic microclimate within the nasopharynx, histamine is an acidic
delivery of drugs into the CNS. [PLoS One. 2011]
pot is filled with warm salt water. The head the rostral migratory stream has been identified as another potential access path for the CNS delivery of
molecule, and mucus tends to become more thick and globular (chunky) under
intranasally administered agents (16). However, the relative importance of the various pathways for CNS
is tilted to the side, and the pot's spout is drug delivery remains unclear.
acidic conditions. Adding ¼ tsp baking soda (about 1.5 grams) to the liter of
inserted into the top nostril. The individual stock solution can be marvelously effective.
In general, transport of substances along the olfactory and trigeminal nerve pathways can happen through Review Intranasal delivery of biologics to the central nervous

breathes through the mouth, keeping it both intracellular and extracellular mechanisms (9). The intracellular mechanisms include uptake into
Creating the saline solution and then using that
system.
for the and
Endocytic base of pathways
exocytic a botanical
[Adv Drug Deliv Rev. 2012]
of the neuronal secretory
olfactory sensory neurons (OSNs) within the nasal cavity via both diffusion and endocytosis (17,18). OSNs
open. Water is slowly poured into the have a demonstrated capacity to endocytose awater decoction
variety of can ensure
substances, including a good
some large extraction
molecules and of botanical constituents. wheat
process and trans-synaptic transfer of [J Comp
germ Neurol. 1985]
agglutinin-
Transneuronal transport of peroxidase-conjugated wheat germ
nostril, and it is allowed to drain through the viruses (19). However, intracellular transport is a slow process, requiring at best several hours and at worst [Exp BraintoRes.
agglutinin (WGA-HRP) from the olfactory epithelium the 1986]
brain
several days (17,20). Extracellular transport, To 1 liter
on the of clean
other hand, is rapidwater
and likely(distilled
accounts fortends
much oftothebe acidic)
Uptake ofadd 9 grams ofmouse
seaolfactory
salt cells.
lower nostril. The same process is then rapid delivery and onset of action observed with intranasalsalt
(iodized CNSistherapeutics
irritating(8,21). Within approximately
to membranes)
exogenous
and 1.5 gms of sodium or potassium
proteins in
[Acta Neuropathol. 1971]

repeated on the second side. When both 45–90 min, extracellular transport delivered the tracer peroxidase to the olfactory bulbs (22). Rapid
bicarbonate. Warm this solution and add 1-1.5 Quantitative
intranasal delivery, as fast as 5–10 min in some cases, of therapeutics to the CNS has been demonstrated
tablespoons
to the brain.
analysis of the olfactory pathway for drug delivery
of loose green [Brain Res. 1995]
sides have been cleansed, the excess water tea (Camellia sinensis) and allow to steep for 10 Review
with a variety of intranasally delivered drugs, confirming the importance of this extracellular transport
minutes anddelivery
Intranasal thentofilter
the central nervous system:
mechanism (7,9,10,12,23–25). This rapid speed through a coffee
of transport filter,
suggests that a French
for many press will eliminate
compounds a large
mechanisms amountconsiderations.
and experimental of debris. [J Pharm Sci. 2010]
is blown out of the nostrils using kapalbhati, To further reduce debris, run the solution
extracellular convection—along the olfactory and trigeminal nerves—accounts for a significant portion of through a 0.45 micron filter, to make See more ...
a kriya/pranayama breathing technique. intranasal delivery to the CNS (9). a sterile preparation, run it through a 0.2 micron filter.
In contrast to the intranasal administration of hydrophilic compounds, which typically results in low or no Sniffing neuropeptides: a transnasal approach to the human
brain. [Nat Neurosci. 2002]
systemic exposure while targeting the brain (10), it can be difficult to avoid systemic exposure with an
intranasally delivered small lipophilic molecule. Using a vasoconstrictor formulation may help reduce Novel vasoconstrictor formulation to enhance intranasal
[J Pharmacol
targeting of neuropeptide therapeutics Exp nervous
to the central Ther. 2009]
systemic exposure of lipophilic molecule (26), but studies on the efficacy of this approach are lacking.
173
INTRANASAL INSULIN: A MULTI-PURPOSE PHARMACOLOGICAL TOOL Go to:
TO IMPROVE CENTRAL NERVOUS SYSTEM FUNCTION
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Nasal Spray Considerations for Allergy

Vitamin A Nasal Spray
2% cromolyn sodium—We purchase a powdered form of this derivative of Ammi visnaga,
it mixes in water or saline with some urging. Can be used with other agents, stabilizes mast
cells, preventing histamine release.
Retinoic acid (RA), a metabolite of vitamin A is a transcription regulator important in tissue
development and regeneration. RA signaling is vital during olfactory system embryogenesis and
2% Quercetin in cyclodextrin-Similar to other cyclodextrin compounds, a 45% cyclodextrin
adult neuronal regeneration, intranasal vitamin A treatment has been shown to improve
solution is made alkaline with 20% NaOH and powdered quercetin is added to the
olfactory functions. Nasal secretion protects the airway epithelium from the harmful effects of
solution and stirred until dissolved, usually 30-45 minutes. Bring final pH to between 6 and
the external environment and Vitamin A contributes to the maintenance of normal physiology by
8. Like cromolyn, it is a mast cell stabilizer.
keeping the mucosa moist and in the regulation of cellular proliferation and differentiation of
epithelial tissues.
1% Glycyrrhizinate is an anti-inflammatory triterpenoid saponin, reduces swelling in the
nasal passage, has an antiviral impact, solubilizes mucus. Tastes sweet.
We use a Retinoic Acid nasal spray that is 8,333 ius/ml in 45% cyclodextrin. Each spray
delivers 833 ius, administering 2 sprays to each nostril 3 times a day yields the10,000 iu/day
0.1% Hyaluronic acid-Can be topically soothing to irritated mucus membranes. Essentially
dosage recommended in the literature for olfactory neuron regeneration.
hydrating in dry climates.

Vitamin A—Increases moisture in the mucus membranes, encourages new tissue growth,
immune-stimulating.

Intranasal Hyaluronidase
Considerations worth
Intranasal hyaluronidase increases the dispersion rate of agents delivered taking into account when
at the same time, breaks down the hyaluronan components of scar tissue, designing a successful
increases the tissue turnover rate in the mucosal cells, disrupts bacterial intervention with
biofilm structures. therapeutic solutions, nasal
600 ius added to a 15 ml saline-based nasal spray yields 40 ius/ml or 4 sprays, eye washes,
ius/spray which is the lowest level of effective dosing, the higher level of wound washes, etc.
dosing is 20 ius/spray or 200 ius/ml. Hyaluronidase can be administered
4 times a day—it is allergenic with longer term use. It makes a better the pH of the
short-term delivery agent. administered solution,

the osmolarity of the

administered solution

and the concentration of

the therapeutic
ingredients.

Carbonic anhydrase
The pH buffering impact of the bicarbonate system is based on
equilibration of CO2 with carbonic acid, carbonic anhydrase
activity, bicarbonate ion, hydrogen ions, the respiratory rate and the
ability of the kidney to reabsorb and excrete bicarbonate and
hydrogen ions into the urine.

CO2 + H2O <=> H2CO3<=>H+ + HCO3-

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Nebulizer Solutions
Nebulization
Generally, you want the pH to be alkaline, COPD patients are an exception as
they are already accumulating CO2 in their atelectatic lungs spaces.
● A clinical useful strategy for administering a large number of Mucus is easier to move under alkaline conditions, smooth vs. chunky and
potentially therapeutic substances to the lung field, head and sticky
neck
Simply making a 0.9% saline solution and adding a ¼ tsp of baking soda per
● The solution itself has therapeutic potential liter will be an effective nebulizer solution for most needs and can be used 4-10
• Alkaline solutions liquefy mucus and stabilize mast cells
times a day and will have a moistening, loosening effect on the mucus.
• Hyperosmolar solutions serve to draw out infectious processes and
expectorate A hyper-salinated solution is also helpful by creating a stronger osmotic
• Hypo-osmolar solutions are hydrating to lung tissues gradient, pulling moisture from swollen tissues.

● A useful beginning solution (Isotonic and slightly alkaline): Any number of herbal teas (be careful with flowers) can be made iso-osmolar
1 tsp (7.5 grams) non-iodized salt by adding 9 grams of sea salt and 1.5 gms of baking soda to a liter of tea.
¼ tsp (1.5 grms) potassium or sodium bicarbonate
per liter of pure water or herbal tea. Black and green tea are astringent, which can be helpful for swollen and
inflamed lung tissues in bronchitis or after an asthma episode.

Nebulized
Solutions
2 tsps sea salt (9 gms)
¼ tsp. Baking Soda (1 gm)
1 Liter Distilled water or
Licorice tea and Lobelia tea
(for asthma)

Melissa and Hypericum tea

(antiviral) Ecological determinants of the respiratory microbiome.
The constitution of the respiratory microbiome is determined by three factors: microbial
immigration, microbial elimination, and the relative reproduction rates of its members. In
health, community membership is primarily determined by immigration and elimination; in
Datura and Lobelia advanced lung disease, membership is primarily determined by regional growth
(antispasmodic) conditions. Adapted from Dickson 2014

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Bacteria normally live in a biofilm state at some point in their life cycle Biofilms that form in the human body are up to ten thousand
The biofilm form of bacteria allows for the presence of microbes that times more resistant to antibiotics than free-floating bacteria,
would not survive in our milieu on their own.
Most bacteria in and on the human body exist in biofilm form. Most
making them very difficult to treat medically. These biofilms
are beneficial commensal bacteria and provide barrier, immune, and are responsible for the extreme persistence of many difficult
metabolic functions to treat illnesses like Legionnaire’s disease, Staphylococcus
aureus (“Staph”), and infectious bronchitis, that can trouble
patients with frustrating symptoms for years.

Pathological biofilms are nearly universally present in: Colloidal silver

• Oral plaque, periodontal disease, abscess Silver can be found as ions in different carriers and
• MRSA infections and other skin infections salts, but with recent advances in nanotechnology,
• Chronic wounds and ulcers the synthesis and use of elemental silver
nanoparticles has gained special attention.
• Chronic sinus infection
• GI disturbances Nanoparticles are clusters of atoms, ranging in size
• Vaginal and Bladder infection from 1 to 100 nm. Silver nanoparticles exhibit
promising chemical, physical, and biological
characteristics due to their large surface-area-to-
Biofilms are the normal life state for bacteria and many fungi volume ratio, tolerance against corrosion and
• Biofilms can be viewed as semi‐independent multicellular organisms with oxidation, and nonreactivity, which makes them
specialized metabolism and immune defenses. suitable for various applications in medicine,
• They are interlinked by filaments of polysaccharide, protein, or strands of genetic including in diagnostics and imaging, orthopedics,
material drug and gene delivery, surgical catheters and
• A gradient of metabolism from aerobic at the surface to anaerobic at the core meshes, medical equipment coatings, and wound
dressings.
develops, allowing resistance to substances which might attack the metabolism.
• In some species, an attached biofilm layer provides nutrients to a superficial layer, Several silver-based wound-dressing products have
which may the secrete antibiotics, reproduce, etc. become available for managing wounds and
• Once aggregated, bacteria in biofilms can dramatically change their functions and controlling infection. Concentrations lower than 10
secretions. ppm are ineffective and higher than 60 ppm are
toxic to healthy tissues

N-Acetyl-Cysteine GLUTATHIONE
An antioxidant component of Glutathione • IT IS HIGHLY OXYGENATED, WHICH MAKES IT VULNERABLE TO ENDOGENOUS
Plays a protective, reducing role in the compound OXYGEN RADICAL PRODUCTION
A major reagent in Phase ll sulfation reactions • IT HAS A HIGH PROPORTION OF UNSATURATED LIPID WHICH MAKES IT
crucial for appropriate detoxification, including VULNERABLE TO PEROXIDATION
histamines and heavy metals
• CATECHOLAMINE RICH AREAS OF NEURAL TISSUE ARE EXCEPTIONALLY
VULNERABLE TO FREE RADICAL GENERATION AS THE CATECHOLAMINES
Improves antibody production, esp. IgA ADRENALINE, NORADRENALINE, AND DOPAMINE SPONTANEOUSLY AUTO-OXIDIZE
Displays significant antiviral
activity against influenza viruses

Exhibits bactericidal properties, breaks down bacterial biofilms of

clinically relevant pathogens including Pseudomonas aeruginosa,
Staphylococcus aureus, Enterococcus faecalis, Enterobacter cloacae,
Staphylococcus epidermidis and Klebsiella pneumoniae

100 mg/ml solution —Dosage 1-5 ml

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RAW MATERIAL PROCUREMENT

COMPOUNDING POWDERS INTO
LIQUIDS AND ASSESSMENT
• YOU ARE OBLIGATED TO ENSURE THE
• SOLUBILITY OF SOLIDS IN LIQUIDS CHANGES WITH TEMPERATURE, PRESSURE, IDENTITY AND PURITY OF THE RAW
AND PH. MATERIALS YOU USE FOR YOUR PATIENTS.
• N-ACETYL-CYSTEINE AND L-GLUTATHIONE ARE ACIDIC, IT WILL TAKE HALF THEIR • ALL RAW MATERIALS HAVE TO BE
WEIGHT IN BICARBONATE TO NEUTRALIZE THEIR ACIDITY. QUARANTINED UNTIL APPROPRIATE
• TO MAKE A LITER OF 200 MG/ML L-GLUTATHIONE WILL REQUIRE 200 GMS OF L- TESTING HAS BEEN DONE OR PAPERWORK
GLUTATHIONE AND 100 GMS OF SODIUM BICARBONATE. THIS IS A VIGOROUS HAS BEEN RECEIVED. SOME SORT OF
CHEMICAL REACTION THAT WILL LIKELY OVERFLOW THE VESSEL YOU ARE MIXING IDENTIFICATION HAS TO BE PERFORMED.
THEM IN, GET A LARGE BEAKER AND ADD THE WATER SLOWLY, ALLOWING THE • C OF A—CERTIFICATE OF ANALYSIS TELLS
REACTION TO SUBSIDE BEFORE ADDING MORE WATER. YOU WHAT PERTINENT TESTING HAS BEEN
• ONCE THE REACTION HAS COMPLETED THE PRODUCT WILL BE PH 7 AND, AFTER DONE ALREADY. YOU MAY HAVE TO DO
FILTRATION, ABLE TO BE USED FOR EYEDROPS, NASAL SPRAYS OR NEBULIZERS. OTHER TESTING—HEAVY METALS,
MICROBIAL CONTENT, PYROGENS.

GLYCYRRHIZIC ACID Glutacyst

TRITERPENOID SAPONIN FROM GLYCYRRHIZA GLABRA-LICORICE
A novel compound consisting of:
HYDROLYSED TO THE BIOLOGICALLY MORE ACTIVE COMPOUND GLYCYRRHETIC ACID,
WHICH INHIBITS THE ENZYME 11 BETA-HYDROXYSTEROID DEHYDROGENASE LEADING TO Glutathione 200 mg/ml
INCREASED CORTISOL LEVELS.
N-Acetyl-Cysteine 100 mg/ml
THE RESULT IS A HYPER-MINERALOCORTICOID EFFECT OF CORTISOL AS IT BINDS WITH
THE SAME AFFINITY AS ALDOSTERONE TO THE MINERALOCORTICOID RECEPTOR. Glycyrrhizic Acid 5 mg/ml
THE INHIBITORY EFFECT ON 11 BETA-HYDROXYSTEROID DEHYDROGENASE IS Na Bicarbonate 152.5 mg/ml
REVERSIBLE; HOWEVER, DEPRESSION OF THE RENIN-ANGIOTENSIN SYSTEM MAY LAST
In distilled water-0.1 micron filter
SEVERAL MONTHS WITH ABERRANT BLOOD PRESSURE EFFECTS.

5-10 MG/DAY THROUGH A NEBULIZER OR NASAL SPRAY GLYCYRRHIZIC ACID REPRESENTS

A SAFE DOSE. Rationale: Improved shelf life,
Used in the clinical treatment of able to stay in reduced state under
hepatitis, bronchitis, gastric ulcer,
AIDS, certain cancers and skin a greater range of conditions.
diseases. It exerts anti-microbial and The presence of a triterpenoid saponin, glycyrrhizic acid,
anti-inflammatory activity through allows for a shift in serum surface tension and STRONGER
several different mechanisms.
Topically, very helpful topically to
IMPACT ON DISPERSING THE SUPERFICIAL LAYERS
inflamed mucus membranes. OF BIOFILM.

BERBERIS FREMONTII/ ROLE OF BERBERINE IN THE TREATMENT OF

MAHONIA TRIFOLIATA/
HAEMATOCARPA ALGERITA
METHICILLIN-RESISTANT STAPHYLOCOCCUS
• Berberine containing plants, similarity in action but not the AUREUS INFECTIONS
same… • MING CHU, MING-BO ZHANG, YAN-CHEN LIU, JIA-RUI KANG, ZHENG-YUN CHU, KAI-LIN
• Generally, a bitter tonic for digestion, a stimulant for liver YIN, LING-YU DING, RAN DING, RONG-XIN XIAO, YI-NAN YIN, XIAO-YAN LIU & YUE-DAN
metabolism, antimicrobial for intestinal tract and for skin. WANG
• Cold and astringent…long considered to be a helpful
lymphagogue and anti-microbial agent in botanical • SCIENTIFIC REPORTS 6, ARTICLE NUMBER: 24748 (2016)DOI:10.1038/SREP24748
medicine.
• Studies have confirmed an anti-proliferative effect of the
root extract on leukemic and psoriatic cell lines, inhibition of • BERBERINE IS AN ISOQUINOLINE ALKALOID PRESENTED IN VARIOUS PLANTS WHICH HAS
IL-8, modulating CD25 lymphocyte activation pathway, BEEN WIDELY USED TO TREAT BACTERIAL DIARRHEA AND GASTROENTERITIS FOR A LONG
interleukin-10 signaling, and tumor necrosis-alpha secretion HISTORY. RECENTLY, BERBERINE HAS BEEN DEMONSTRATED TO BE A STRONG SYNERGIST
in human peripheral blood mononuclear cell (PBMC) FOR ANTIBIOTICS. SYNERGISTIC INTERACTIONS BETWEEN BERBERINE AND COMMONLY
subpopulations. USED ANTIMICROBIAL AGENTS EXHIBIT THERAPEUTIC BENEFITS AGAINST A BROAD
• Root extracts exhibit a moderate cytotoxicity and changes SPECTRUM OF PATHOGENIC MICROORGANISMS, INCLUDING METHICILLIN-
in the signaling pathways linked to cell adhesion, RESISTANT STAPHYLOCOCCUS AUREUS (MRSA). MANY REPORTS HAVE SHOWN THAT
proliferation, migration, and apoptosis of tumor cells.
COMBINED USE OF BERBERINE IMPROVED THE BACTERICIDAL ACTIVITY OF ANTIBIOTICS
• An effective anti-microbial and biofilm disrupting tea for
AGAINST MRSA, LOWER THE MICS OF ANTIBIOTICS, AND NOTABLY DECREASED ADHESION
eyedrops/eyewashes/ nasal sprays and nebulizers.
AND INTRACELLULAR INVASION OF MRSA.
• Dried root tincture 1:5, dosed at 10-60 drops 3-4 time per
day

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Rauwolfia serpentina-Indian Snakeroot

Sarpaghanda
An ancient and highly respected plant ally in Ayurvedic
medicine with a history of use that dates back almost 3000
years-Caraka Samhita, circa 400 BC.
Medical practitioners have employed this versatile plant
for millennia in the treatment of all sorts of mental
disorders including, anxiety and nervousness, headaches,
tension, most forms of insanity and snakebites.

Contains the alkaloid reserpine that makes the pre-

synaptic storage vesicles leaky so that the stored contents
get broken down by MAO before they are able to be
released into the cleft effectively blunting the signal to the
next neuron.

Start with low dosage-10-15 drops of tincture—it takes 2

weeks to get to full effect and adjust dosage

Rotary evaporator
Reserpine is an indole alkaloid whose antipsychotic, and
antihypertensive effects are a result of its ability to deplete A reduced pressure distillation: a solution
catecholamines. in a round bottomed flask (A) is placed in
These substances are normally involved in controlling the water bath of the apparatus (B) and
heart rate, force of cardiac contraction and peripheral rotated while the system is partially
vascular resistance.
A bitter tea made from the roots of Rauwolfia serpentina,
Reserpine evacuated by vacuum pump (attached to
H). The reduced pressure in the apparatus
causes the solvent to boil at a lower
containing reserpine, have a calming, sedative action that temperature than normal, and rotating the
is considered antidepressant. flask increases the liquid's surface area and
thus the rate of evaporation. The solvent
Notably, reserpine was the first compound shown to be an vapor condenses when it comes into
effective antidepressant in a randomized placebo- contact with a water condenser (F) and
controlled trial. drips into a receiving flask (G). When the
solvent is removed, the concentrated
compound is left in the flask. One
difference between distillation and rotary
evaporation is that the distillate is most
often retained in distillation while the
residue is retained in rotary evaporation.

SCALES PH METERS
When choosing a pH meter, prioritize accuracy, calibration features, electrode type,
Often a trade-off between accuracy and capacity—you might need at least temperature compensation, and portability based on your specific needs, whether for lab
two scales, one that measures milligram amounts—often with a glass cage to work or field use.
protect from air currents. As well as a larger capacity, grams to kilograms— Those models that are made for the field/ecology studies are far more durable and
depending on your particular needs. Calibrate scales weekly or even typically last several years if treated well.
daily…accuracy counts. You do need to calibrate your pH meter on a regular basis—at least once a month
depending on your useage. Keep records of your calibration.

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WHY IS PROPER GARBING IMPORTANT?

• STRATUM CORNEUM: SURFACE OF
SKIN COMPOSED OF DEAD SKIN CELLS
• PEOPLE ARE “PARTICLE GENERATORS.”

• EVEN THOUGH WE CAN’T “SEE” IT, WE

SHED OVER 1 MILLION SKIN CELLS PER
HOUR AND THOSE CELLS CONTAIN
MICROORGANISMS!
• THE HUMAN BODY HARBORS AN
AVERAGE OF 150-200 DIFFERENT
CLASSES OF BACTERIA.

• THE BODY SHEDS 5 GRAMS OF SKIN

FRAGMENTS EACH DAY ALONG WITH
SHEDDING 1 LAYER OF SKIN EVERY 5
DAYS (SIZE RANGE 10 TO 300
MICRON – 1000TH OF A MM).

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Swinging the Pendulum-Acid-Base Chemistry for Herbalists—

Dr. Kenneth Proefrock

We discuss the natural origins of acids and bases, historical methods of extraction,
isolation and concentration of such strongly acting chemical agents. We will include
discussion of the impact of pH on alkaloid expression in botanical extraction practices,
nixtamalization, bicarb vs vinegars, acetracts and spagyric tinctures, culinary ash, and
some potentially interesting insight into the manufacture of plant dyes and color changes
with shifting pH.

Consider a molecule of water H2O, sitting at room temperature, in a glass. At any

given moment that molecule is disassociating into two components--H+ and OH-...if that
is happening exactly half the time and the water is pure, we can assume the solution has a
neutral pH, around 7, we might say that there is as much acid potential as there is alkaline
potential in that solution. If that pH is lower than seven, the water is acidic and if over
seven, it is basic or alkaline. If none of that makes sense to you, that is ok. By the end of
this discussion, it will make a lot more sense. This is the world of duality in chemistry,
acid and alkaline. The original concept of acidity comes to us from the ancient Greeks
who used the term oxein for “sour-tasting” substances, which mutated into the Latin word
acetum (associated with vinegar) which became anglicized to today's “acid". Acidic
substances not only taste sour but also corrode metals and dissolve minerals into solution.
In contrast, bases (alkaline agents) tend to taste bitter or metallic and have the ability to
counteract acids, sometimes with violent effervescence—and so, are associated with the
acids in their chemical characterization. The term "alkaline" is derived from a 10th
century Arabic word al-qalī which meant "the burnt ashes of saltwort (a common name
that applies to plants of the Salsola, Soda (Seidlitzia), and Salicornia families) which
grow in alkaline soils, and whose ashes are good sources of alkali material (KOH,
NaOH). The idea that acidity/alkalinity was associated with the presence/absence of
hydrogen ions was not proposed until the mid-19th century by the German chemist Justus
von Liebig (1803–1873) and in the 1890's the Swedish chemist, Arrhenius (1859-1927),
went so far as to provide a definition of acids as "substances delivering hydrogen cations
(H+) to the solution” and bases as “substances delivering hydroxyl (OH-) anions to the
solution”. He also proposed that the mechanism by which acids and bases interacted to
neutralize one another was by forming water and the appropriate salt, (H+ + OH - <==>
H2O ) which is still accepted dogma today. The class of bases has been expanded to
include any substance capable of binding protons (H+), and as an example (OH-), and the
definition of acid can include any substance that releases a proton (H+). These definitions,
relying on protons and hydroxyl ions as they do, generally relate to reactions in water
solutions and we should remember that we are not dealing with absolutes here as much as
relative values in a continuum of change--there is a constant flux between intact H2O
molecules and the disassociated ions,
H+ and OH-, variables like temperature and atmospheric pressure also have a bearing on
this flux, which makes proving any of it a bit of a moving target.

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We cannot know how significant a phenomenon is until we can measure it...and

the earliest laboratory for exploring the universe of acids and bases was the textile dye
industry. Early experiments revealed that commonly used dyeing agents became different
shades and even different colors when a vinegar was added or when urine or the ashes
from a particular burned plant were added to the dyeing solution. In ways that only
human expression in the form of fashion can drive industry and understanding, a
sophisticated awareness of the acid-base spectrum became established, people want
vibrant and unique colors, subtle adjustments in the amount of an acid or a base could
accomplish such color change. One of those sources of the purple dye, orcein, also called
orchil, was any of several types of lichen known as "orchella weeds", found throughout
the world, Roccella tinctoria is a commercially important example. These lichens
produce orchill dye precursors that are traditionally soaked in urine (or other sources of
ammonia) and water while under constant stirring to encourage oxygenation and,
ultimately, fermentation, to develop a deep purple color. If the conversion is carried out
in the presence of potassium carbonate, calcium hydroxide, and calcium sulfate (in the
form of potash, lime, and gypsum in traditional dye-making methods), the result is
litmus, a more complex molecule whose manufacture was described by Cocq in 1812.
Litmus is an orchill dye whose color change is calibrated to different pH values around
the range of 4.5-8.3. Litmus is red under acidic conditions (less than pH of 4.5) and blue
under alkaline conditions (greater than pH 8.3), purple indicates a neutral pH (between
4.5 and 8.3). The word "litmus" comes from an Old Norse word for “moss used for
dyeing” and as early as 1300, the Spanish physician Arnaldus de Villa Nova reported
using litmus to study acids and bases. Eventually, filter paper embedded with dried litmus
extracts became a common laboratory method of evaluating acids and bases, the original
"litmus test". In his 1909 paper in Biochemische Zeitschrift, Danish chemist Søren
Sørenson proposed a new color change assay for acidity based on electro-chemical
principles and the use of a glass electrode. In this paper, he defined the concept of acidity
as the "negative logarithm of the hydrogen ion concentration in a solution", a number he
called the 'potential of hydrogen' or pH. He was one of the first to define pH and to
attempt to use electrostatic methods of measurement which involved a hydrogen ion
electrode in combination with a calomel reference electrode. The usefulness of the pH
concept was largely ignored by chemistry and biology until Leonor Michaelis (of
Michaelis/Menten enzyme kinetics fame) published a monograph establishing the critical
importance of pH to enzyme activity and the relative importance of measuring pH to
other arenas of analytical research. The modern measurement of pH was revolutionized
in 1930 with the development of a hydrogen permeable glass electrode, which, in 1934,
was employed by Arnold O. Beckman in his "acidimeter", an invention he created for the
California Fruit Growers Association. The citrus growers needed a portable way of
monitoring fruit acidity during the production of pectin and citric acid—sulfur dioxide
was commonly used as a preservative and interfered with other methods of testing.
Beckman designed a sensitive and sturdy instrument that used a pair of vacuum-tube
signal amplifiers and gas permeable glass electrodes to measure the pH of any solution.
Variations on Beckman's design are still used in laboratories today all over the world, it is

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a consistent and reliable measuring device. The pH scale runs from 0-14 and is set up in
an inverse manner such that the acidic solutions are on the lower end of the scale-0.5-1.5
and the extreme alkaline solutions are in the 13.0-14.0 range, neutral pH is 7.0.
There are strong acids and weak acids as there are stronger bases and weaker
bases, the strength of these compounds is determined by their degree of disassociation,
the stronger the acid or the base, the more completely the H+ and/or the OH- is separated
from the parent molecule and the more electrically conductive the solution becomes. The
stronger the acid or base, the less likely there will be a reversible equilibrium--that is the
tendency to reform the parent compound once the respective ions have disassociated;
weaker acids and bases will move between ionized and non-ionized molecular forms with
a proportionate ease, whereas, a strong acid or base, once ionized tends to not reform the
original compound. Hydrochloric acid (HCl) is the strongest naturally occurring acid--
and is part of the digestive process for many animals. Lime, calcium hydroxide
(Ca(OH)2, is the strongest naturally occurring base and is formed from heating limestone
(CaO) often through volcanic activity or intentional cooking. There are only a handful of
strong acids and strong bases and there is an almost infinite number of weak acids and
bases, they represent critical components in the electron transport chain and the
oxidation-reduction reactions that biological systems use to generate energy and stay
alive, they also represent a vast buffering system for the constant adjustment of local pH.
In mammals, a part of that buffering system involves the presence of large negatively
charged proteins like albumin being widely present and available to absorb a certain
amount of acid and alkali material in order to preserve a more moderate pH range.
When applying aqueous solutions to living systems, the pH of that solution is a
therapeutically useful parameter to consider. Qualitatively, the most important pH
buffering system within the body is the bicarbonate buffer system, which involves the
lungs and the kidneys. This system is unique in that it remains in equilibrium with
atmospheric air through the respiratory system; thus, it is an open system with a much
greater capacity to buffer body fluids than any closed system would manage. The pH
buffering impact of the bicarbonate system is based on the equilibration of CO2 with
carbonic acid, the activity of the enzyme carbonic anhydrase, bicarbonate ion and
hydrogen ion concentrations, respiratory rate, and hydration status affecting the kidneys'
ability to reabsorb and excrete bicarbonate and hydrogen ions into the urine.

CO2 + H2O <=> H2CO3<=>H+ + HCO3-

In our reversible chemical process, increasing the reactants on the left tends to push the
reaction to the right, i.e., an accumulation of water and CO2 in the tissues of the lungs
tends to increase tissue production of carbonic acid and, ultimately, bicarbonate and
protons. This is why one's breathing rate becomes a primary method of managing internal
pH and why breathing into a paper bag when one is hyperventilating can be helpful; the
re-breathing of the CO2 tends to make the system, initially, more alkaline, which tends to
have a relaxing effect on the nervous system. Purposely increasing the bicarbonate levels
in tissues by applying it in an aqueous solution leaves the tissues more alkaline and

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increases CO2 and water movement out of the body through the lungs and kidneys, often
a very beneficial effect for patients with restricted airways that are not as able to perform
that role. While the lung and changing respiratory rates plays a relatively critical role in
managing pH, the kidney plays a similar and more long-term role by actively excreting
acid, as H+ or base, as HCO3- into the urine, rendering the urine either acidic or alkaline.
An essential consideration in this process is the role of adequate amounts of water in
maintaining appropriate pH levels; as the old chemistry adage reminds us, “where the
water goes, so go the electrolytes.” Sufficient potassium in the system is a crucial factor
in how the body moves acids into the intracellular protein buffer system. Potassium (K+)
has a relatively alkalinizing effect on physiology through intracellular K+ being
chemically exhanged for acidic H+ in the plasma proteins. As the H+ concentration
increases, the intracellular protein buffering system can have access to and neutralize the
plasma H+ by exchanging the similarly charged but not acidic (not a proton) K+ which
results in transient increases in plasma potassium levels with the more long-term
diminishment of the intracellular potassium reservoir, leading ultimately to a potassium
deficiency. The reverse of this process is how the body deals effectively with metabolic
alkalosis; that is, as the plasma levels of H+ decline; potassium in the plasma is
exchanged for intracellular hydrogen ions to compensate. Another point worth stating is
that bronchodilators like Albuterol sulfate and levalbuterol, often used chronically by
asthma and COPD patients, have a known side effect of reducing the body's intracellular
potassium stores, which is associated with aberrations in heart rate.
Mucus is a large protein/polysaccharide structure involved in maintaining
membrane health that can be dramatically affected by shifting both osmolarity and pH. It
is a conglomeration of the secreted protein mucin and the numerous saccharides that
glycosylate it, creating branching molecular structures that serve to establish a degree of
slimy-ness to crunchy-ness in the matrix of the mucus, aka snot vs. boogers. Some of the
most critical of these saccharides are the family of sialic acids and, also within this
family, the compound neuraminic acid. Sialic acids contribute significantly to the
viscosity of mucus; the more acidic the environment, the higher the viscosity or thickness
of the mucus; alternately, the more alkaline the internal environment, the thinner the
mucus. The metabolically acidic nature of the infectious process creates a thickening of
the mucoid secretions, making them significantly more “sticky,” a measure which helps
impede further progression of the infection but also more difficult expectoration. The
relatively acidic environment in the airways and other mucus membranes contributes to
tissue constriction through a neural reflex (acidity creates ‘tension’ in the tissues),
inhibition of histamine breakdown, and contributes to tissue irritation. One of the reasons
the Influenza family of viruses is so virulent is that it has evolved a neuraminidase
enzyme that allows the viral particles to cleave through the thickening and protective
neuraminic acid component of the mucus and infect adjacent tissues to the primary site of
infection. Neutralizing the acidity of mucus makes it a looser, thinner material,
facilitating liquefaction of the more problematic secretions, promoting relaxation and
improvement of blood flow into and out of the affected tissues, and inactivating
histamines. Applying relatively alkaline solutions to the affected tissues represents a

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decided advantage in treating patients with many congestive conditions of the mucus
membranes. I find that using potassium bicarbonate, where reasonable, as a buffer to
bring the pH of a topical solution into a slightly alkaline realm adds even more
significantly to the therapeutic potential.

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Osmolarity is another variable worth consideration when we are talking about

therapeutic solutions, it is the density of the solution based on the number of moles of
dissolved particles per liter of solution. The root of the word is osmosis which describes
the movement of a solvent across a semipermeable membrane toward a higher
concentration of solute (lower concentration of solvent). The solvent is typically water in
biological systems, but osmosis can occur in other liquids, supercritical liquids, and even
gases. When a living cell is submerged in pure water (a hypo-osmolar solution), the water
molecules pass through the cell membrane from an area of low solute concentration
(outside the cell) to high solute concentration (inside the cell), if the material inside the
cell is unable to leave the compartment, the cell swells. If the cell is submerged in
saltwater (a hyper-osmolar solution), water molecules move out of the cell into the more
solute dense exterior environment, and the cell shrinks. When the solvent has a similar
amount of solute on both sides (iso-osmolar), water molecules pass in each direction at
precisely the same rate. There is no net flow of water through the membrane. Osmolarity
represents a way of determining the relative concentration of osmotically relevant
particles in any solution. Those solutions considered iso-osmolar to human physiology
have roughly the same amount of dissolved solute as the bloodstream—defined as
roughly, 280-310 milliosmoles/ml. Solutions that are relatively hypo-osmolar, containing
less than 280 mOsm/ml, are less dense, more 'watery,' and tend to leave behind more of a
water portion in the tissues; they can be relatively hydrating to body tissues. Solutions
that are relatively hyper-osmolar, greater than 310 mOsm/ml, tend to pull more fluid
from the tissues and leave them relatively more dehydrated, reducing tissue swelling.
These are helpful therapeutic qualities for topical solutions; for patients who have
chronically dry eyes, a slightly hypo-osmolar solution can be a phenomenal way to
hydrate the tissues while washing away irritating debris. A hyperosmolar solution can be
helpful in conditions of edema in the throat, sinuses, eyes, or skin by drawing fluid out of
the interstitium, which is the rationale behind gargling with salt water for a sore throat.
An iso-osmolar preparation commonly used in medicine is “normal saline,” a
mixture of 0.9% sodium chloride in water; it is the most commonly employed
intravenous fluid in the treatment of dehydration. 0.9 % means that there is 9 mg of salt
in every ml of water or 9 gms of salt in a liter of water. There is a simple calculation to
determine the osmolarity of a solution based on how many osmotically relevant particles
are present in a 1 Molar solution (1 Mole of material per liter). NaCl has two ionizing
particles, Na+ and Cl-, which means we will have to account for both ions in our final
calculation. A 1M solution would require 58.4 gms of NaCl (Na+=23 gms/mole, Cl-
=35.45 gms/mole) in 1 liter of solution, also represented as 5.84%. Normal saline, at 9
gms/liter divided by the Molar weight of NaCl (9 gms/58.4 gms), yields 0.154 Osm/L for
each osmotically relevant ion. Adjusting to account for both ions, we get an osmolarity of
0.308 Osmoles/Liter...or 308 milliosmoles per liter. Therefore, normal saline is an iso-
osmolar solution because it falls within the range of 280-310 mOsm/L.
This can be tricky for some; at the risk of belaboring the point, consider a 5%
solution of dextrose (D5W), a commonly used intravenous preparation. There is only one

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osmotically relevant particle, and that is dextrose. Dextrose has a molecular weight of
180.156; however, it exists as a monohydrate, so we have to add the molecular weight of
one water molecule, which is 18. A 1M solution would consist of 198 grams of dextrose
monohydrate in 1 liter of water; a 5% solution has 50 grams in the liter of water. Using
our previous ratio, 50/198=0.252 osmoles/liter or 252 milliosmoles/liter...this is a
physiologically hypo-osmolar solution. In another example, MgCl2 is a commonly used
solution that disassociates into three osmotically relevant particles, Mg+, Cl-, and Cl-, and
its molecular weight is 95.2 gms/mole. It is typically made as a 10% solution, 100 mg/ml.
A liter of MgCl2 would require adding 100 gms to a liter of water, and a 1M solution
would require 95.2 gms to be added to a liter of water. Our relevant Molar ratio is
100/95.2 and yields 1.05 osmoles/liter for each osmotically relevant ion and a total of
3.15 osmoles/liter (3,150 mOsm/L) when you add the values of each of the three ions
together, a hyperosmotic solution. In a final example, magnesium sulfate exists as
magnesium sulfate heptahydrate, commonly called 'Epsom salt,' after a bitter saline
spring in Epsom, England. It is generally made as a 50% solution, 500 mg/ml. It has a
molecular weight of 246.9 (Mg=24.03, S=32.06, O=16; MgSO4=120.09 + 7 H2O
(7*18)=246.9) and has two osmotically relevant particles, Mg+ and SO4-; a 1M solution
would require 246.9 gms in 1 liter of water. Our 50% solution is 500 gms/liter; dividing
that concentration by our Molar weight of 246.9 gms yields 2.028 Moles/liter, multiplied
by the number of active ions, 2, gives us 4.06 osmoles/liter or 4,060 milliosmoles/l, an
even more hyperosmotic solution than the previous example.
A simplified formula for calculating osmolarity is as follows:
milliosmoles per Liter = mass in gms/molecular weight (g/ml) multiplied by
# of relevant ions multiplied by 1000.
Using our 0.9% NaCl example...9gms/58.4 gms x 2 x 1000 = 308.21

Using 50% MgSO4: 500gms/246 gms x 2 x 1000 = 4060 mosm/L (It is more
useful to relate such solutions as mOsm/ml as we generally use ml doses of such
strong additives, which is 4.06 mOsm/ml).

Using 1,4 beta-hydroxy-propyl-cyclodextrin--molecular formula: C63H112O42

divided by 1541.5 g/mol gms--0.292 or 292 mOsm/ml, which yields an iso-
discussion.

Oxidative damage is implicated in most disease processes, and it is becoming

more and more common knowledge that anti-oxidants have great value in preventing and
treating some of the major medical conditions of the modern world. The processes of
oxidation and reduction are essential to the production of energy in our bodies, the ability
to protect ourselves from the free radical fallout of these processes is what makes the
difference between “burning out and fading away”, to paraphrase Neil Young.
Essentially, the processes of oxidation and reduction describe the movement of electrons
between molecules. I learned a mnemonic in a college chemistry course that still serves
me to this day. "LEO says GER"--Loss of Electrons is Oxidation, Gain of Electrons is

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Reduction, that is, when a molecule loses an electron, it is in a relatively more oxidized
state, its relative charge is +1, and when a molecule gains an electron, it is in a relatively
more reduced state, its relative charge is -1. Consider a structure that could sequester +1's
on one side and -1's on the other side of a membrane, that would be a battery. It is exactly
this movement of charge across a membrane that generates the energy that powers a cell.
The charge might be H+ ions on one side and OH- on the other side, and the membrane
has a mechanism, like an electrical trigger, that allows it to immediately open up channels
that allow the ions to flow through and release their energy. The flow of electrical current
through living tissues is hard on the tissue, acids and bases are hard on tissues, our
systems have developed methods to use other charged molecules to generate electrical
activity, like Na+, K+, Ca+, Mg+, Cl-, that are not as reactive and abrasive to living tissues.
The specialized membranes that are involved in electron transport have evolved a family
of waxes, known as ubiquinones, CoQ10 is an example, that impart an exceptional anti-
oxidant effect, essentially containing the free radical electron "bullets" in its waxy
molecular structure. The ability of any compound to act as an effective antioxidant is
dependent on its ability to act as an electron “sink,” that is, how well it can give and take
electrons without being compromised in the process. The molecular architecture of those
compounds that have proven themselves good anti-oxidants is typically rather elaborate
and self-supporting. One of the great deficiencies in the magic bullet theory of
therapeutics, where modern science tries to specify the “active constituent” of a plant
substance and then purify and concentrate that substance to increase its effectiveness, is
that the complementary architectural chemical cohorts are lost through refinement.
Vitamin C is considered the penultimate water soluble anti-oxidant, yet more than 250
mg/day of pure vitamin C tends to become unstable under the oxidative load of modern
life and as it is unable to give and take electrons, it breaks down and actually allows more
oxidative damage than if it weren’t present in the first place. Beta-carotene and Vitamin
E are fat soluble anti-oxidants and have the exact same issues when they are administered
in purified forms, this is one of the reasons why modern medicine is now second guessing
the recommendation of these agents for patients with heart disease and smokers. When
we consume these items as plant constituents or as complexes like mixed carotenoids,
mixed tocopherols or vitamin C with flavonoids, they are significantly better at
quenching free radical electrons without sacrificing themselves in the process.
Antioxidants with redundant and self-supportive molecular architecture help neutralize
free radicals, especially oxygen molecules lacking electrons. These free radicals, which
are produced through normal metabolism and detoxification processes, scavenge their
missing electrons from other molecules, and in the course of doing so may cause damage
to important cell components such as fats, proteins, or DNA. The best protection against
oxidative damage is a diet rich in color, full of flavonoids and anthocyanidins. The
flavonoid family of polyphenols is one of the largest with over 4000 members; they act as
anti-oxidant pigments and are responsible for the yellows, reds, blues and purples that
color the natural world. The entire family of flavonoids have been shown to have anti-
bacterial, anti-inflammatory, anti-allergic, anti-mutagenic, anti-viral, anti-neoplastic, anti-
thrombotic and vasodilatory activity. The potent antioxidant activity of flavonoids and

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their ability to scavenge hydroxyl radicals, superoxide anions, and lipid peroxy radicals,
are among the most important of their functions; this activity is also what allows
flavonoids to accomplish many of the aforementioned actions in the body.
One particular food source that has been a crucial part of the history of the cultures
of meso-america and the desert southwest is maize, corn, Zea mays. In fact, corn is part
of the biological and cultural heritage of several Latin American countries, including
Mexico, with 59 different varieties, and Peru with 55 different varieties. Phytochemicals
from corn have received less attention than those of fruits, vegetables and other grains
even though the consumption of corn has been linked to the reduced risk of chronic
diseases including cardiovascular disease, type 2 diabetes, obesity, some cancers and with
the improvement of digestive tract health1. Maize grows in a myriad of different shapes
and color shades, such as blue, black, cherry, purple and red, colors from pigments
related to phenolic, flavonoid, carotenoid, and terpene compounds, including
anthocyanidins, in one or more of the kernel structures: pericarp, aleurone and/or
endosperm. In Central America, the people developed a process called nixtamalization by
the Aztecs (from the Náhuatl word nextli, “ashes” and tamalli, “cooked corn
dough”) developed for the preparation of maize which involves cooking and steeping
maize in a lime (CaO and CaOH) solution (pH > 11) which softens the pericarp, hydrates
the endosperm, partially solubilizes proteins and cell walls, facilitates starch swelling,
and gelatinization. This process removes mycotoxins like fumonosins and bacterial
contaminants in stored foods. Some 50%–80% of the niacin in maize occurs in a bound
form as niacytin or niacinogen, which is biologically unavailable and renders the maize
deficient in niacin until it is nixtamalized2. The process also enhances the color, the
flavor, and the texture of the masa and makes it a better source of calcium and iron.
The best raw materials make the best finished product and so whole, sound,
mature kernels of maize with a high proportion of hard to soft endosperm are preferred
and yield more masa and tortillas after nixtamalization. During the cooking and steeping
of the nixtamal, the pericarp is converted into gums and some insoluble materials that
bind water and improve the texture of tortillas. The maize must be cooked uniformly to
provide adequate hydration and partial solubilization so that grinding produces a non-
sticky masa that holds itself together and can be formed and baked into a desirable
tortilla. Table tortillas are excellent when fresh but often become hard after several hours,
alkaline tortillas retain softness and flexibility longer than regular tortillas because starch
retrogradation is inhibited by the negative charges on the starch chains at pH > 9. Many
commercial tortillas are acidified (pH 5.0–5.5) to activate preservatives, but starch
retrogradation and staling are not inhibited at this pH. The process of nixtamalization
begins with whole maize cooked in excess water containing 0.5%–2.0% of hydrated lime
(CaOH)--that is, 5-20 grams per kilo of corn, at 83–100°C for 50–60 min, then cooled to
68°C and allowed to steep for 8–24 h. During this process the endosperm and germ are
softened, the starch is partially gelatinized, and the alkali solubilizes cell walls leading to
a weakened pericarp that is easier to remove. The nixtamal made by the traditional
process is washed to remove loose pericarp and excess lime and is then immediately
stone-ground to produce masa. The wet-ground product that is obtained as a dough

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contains pieces of endosperm, aleurone, germ, pericarp, free starch granules, free lipids
and dissolved solids that form a ‘glue-like’ material that holds together the masa
structure. There is no gluten in the masa dough; cohesion of the mass is due to the surface
tension of the water and is most successful when the particle size of the material is fine,
and the amount of water contained is just enough to fill the spaces between the particles.
The masa is flattened, shaped and baked on a griddle for 39s at 280°C to make tortillas.
Not only does nixtamalization alter the taste of maize, chemically change the kernels
making several otherwise unattainable essential amino acids and B vitamins more
digestible, nixtamalization makes maize a food you can safely obtain 40% or more of
your daily calories from and still live a happy, healthy life. Non-nixtamalized maize is
not nutritionally complete, and a person receiving more than 40% of their calories from
“raw” maize (that isn’t also accompanied by a complementary protein like beans) would
suffer from chronic malnutrition. “Corn sickness” was a serious epidemic in many parts
of the Old World after maize was adopted and incorporated into peasant diets, and was
even an issue in the American South during the Great Depression when Euro-Americans
and Americans alike, whose culinary knowledge of maize derived from the Old World,
turned to maize as a dietary staple, ignorant of the Aztecan magic that made it a better
food.
Intentional use of fire is one of those things that distinguishes humans from the
other animals, the production of warmth and for the conversion of materials from one
form to another (clay to pottery, wood to ashes). Even the ashes left over from the fire
turn out to have useful properties, ash mixed with fat creates soap, which the Egyptians
figured out as a medical treatment for crocodile bites in 3000 BCE. Such a substance was
also useful for other types of cleaning, even cooking and for medicine. The major
components of wood ashes depend on the wood being burned; they are generally
potassium carbonate (potash) and sodium carbonate (soda ash). From a chemical
standpoint these two compounds are very similar and had been indistinguishable from
one another until the 19th century. The elements in the first column of the Periodic Table,
including sodium and potassium, are called the alkali metals, alkali substances tend to
have a bitter taste and a slightly soapy feel when rubbed in the fingers. The isolation of
alkali is the precursor to making true soap and the isolation of potash was that original
breakthrough (although everything that follows here is likewise true for sodium
carbonate), potassium carbonate becomes potassium and carbonate as it ionizes in water:
K2CO3(s) -----> 2 K+(aq) + CO32-(aq)
Once in solution, the potassium ions are unreactive. Such an ion is referred to as
a spectator ion because it does not participate in further chemical reactions. The
carbonate ion, on the other hand, acts as a base in aqueous solution, that is, it absorbs
hydrogen ions wherever it finds them. The reaction we write depends on whether the
solution was acidic or basic to begin with. In acidic solution we can write:
CO32-(aq) + H+(aq) <-----> HCO3-(aq)
while in alkaline or neutral solution we write:
CO32-(aq) + H2O(l) <-----> HCO3-(aq) + OH-(aq)

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The carbonate ion will react with whatever species is around. If there is an abundance of
hydrogen ions (acidic solution) a hydrogen carbonate ion, or bicarbonate ion is formed.
If there is not much hydrogen ion around, carbonate will steal a hydrogen ion from water,
leaving a hydroxide ion behind and producing an alkaline solution.
There are two more reactions that further complicate the picture. First, if the solution is
really acidic, the bicarbonate ion can also stick to a hydrogen ion and produce carbonic
acid:
HCO3-(aq) + H+(aq) <-----> H2CO3(aq)
or
HCO3-(aq) + H2O <-----> H2CO3(aq) + OH-(aq)
Carbonic acid can decompose into water and carbon dioxide gas:
H2CO3(aq) <-----> H2O(l) + CO2(g)
This sequence of equilibria is also how beverages are carbonated, when water is
pressurized under carbon dioxide gas, some of the gas dissolves and combined with water
forms carbonic acid. Some of the carbonic acid splits into hydrogen ion and bicarbonate
ion and the bicarbonate ion further splits into hydrogen ion and carbonate ion. All five
species will be present but depending on the pH of the solution there will be more of one
than another, keep it under pressure and it will stay 'carbonated'. Open it up and the CO2
gets released as bubbly gas and the pH of the solution adjusts accordingly.
The sodium and potassium carbonate that is present in culinary ash is also used as
a leavening agent in cakes, tortillas and breads. The purer that this can be made, the better
it works and the less grit it leaves behind. Wood ash is a complex mixture of all the non-
flammable, non-volatile minerals which remain after the wood and charcoal have been
burned away, the presence of carbon dioxide in the hot fire gases has converted many of
these minerals to their carbonate form. Most ashes consist of predominately sodium and
potassium carbonate, sodium and potassium chloride, silica, and calcium carbonate.
Adding ashes to water allows the water-soluble potassium and sodium salts to dissolve
while the insoluble silica and calcium carbonate will settle to the bottom. Filtering the
water and eliminating the solids gives us a fairly clear liquid of some concentration of
chlorides and carbonates...To separate the chlorides from the carbonates, we will exploit
the greater solubility of carbonates in hot water by bringing the liquid to a boil and
continue boiling until enough water boils away for an insoluble precipitate to form.
Caution: This solution is alkaline and caustic, as it boils along, it splashes--keep it
covered, use gloves and goggles, this stuff will eat you. The precipitate is very likely a
mixture of sodium and potassium chloride, and maybe some other chlorides and boiling
is continued until half of the remaining water is removed, when we can be reasonably
certain that only the soluble carbonates remain in solution. A brown coffee filter is your
friend, pour the hot solution through the filter and discard the solid chlorides. As the
liquid cools to room temperature, the less soluble sodium carbonate will precipitate first
leaving the more soluble potassium carbonate in solution, the sodium carbonate can be
filtered out of the remaining solution and, when boiled to dryness, leaves behind fairly
pure solid potassium carbonate or potash. It takes a lot of wood to make a little ash and a
lot of ash to make a little potash. For the purposes of culinary ash, we are really ready for

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use with both sodium and potassium carbonates present, so once the chlorides have been
filtered, the remaining solution can be used. We know that it is alkaline, but we don't
know how alkaline, a pH reading would be nice, in the absence of a pH meter, the
solution can be boiled until the water is gone and the remaining precipitate is relatively
pure sodium and potassium carbonate in some unknown ratio but that is your culinary ash
primary constituent, you can leaven grain products with it, there just needs to be some
acidic elements present in the rest of the material. Sodium carbonate is sold as washing
soda, soda ash and soda. You can buy washing soda in some grocery stores, on the
laundry detergent aisle, next to the borax. It is used to remove calcium from hard water
by forming an insoluble precipitate of calcium carbonate. Sodium bicarbonate is a much
milder alkali than sodium carbonate, is sold as baking soda, or sodium hydrogen
carbonate. It is used in baking, as the name suggests, and is a common ingredient in
antacid tablets. You can buy baking soda in the grocery store on the baking goods aisle.
In the presence of acids, it gives off carbon dioxide, which makes bread and cake nice
and fluffy.
Traditional culinary ash was made from plants that were relevant to the people
using them, the Navajo have a long tradition of using Juniper wood for culinary ash, they
burn it really hot and preserve the lighter ash components, the smokey flavor that it can
impart is part of its charm, in this author's opinion, and that gets lost when we wash it and
filter it. There are several references to the use of beanstalk ash in maize dishes in the
ethnohistories of the people of the Eastern Woodlands, specifically as either a
preventative treatment or remedy for various diseases, including intestinal worms. The
association between maize, ash, and health is also apparent in the social nature of the
hominy foodway, which is the Eastern Woodland variation on nixtamalization. Alkali
processed corn, hominy, has been regarded as a sacred, ancestral food and still has
importance as a sick food, and a ceremonial dish. According to du Pratz: “When the
natives are sick they eat no fish and very little meat, and they even abstain from that
entirely if the nature of the malady demands it. Then they take only hominy or meal
cooked in meat broth.2.5” We also see this association on a social level in the Pishofa
Ceremony practiced by the Chickasaw and Choctaw. While pishofa (hominy prepared
with meat) is not used as a food to nourish the patient, it is the primary dish prepared and
eaten by the attending doctor, friends, and family who maintain a multi-day vigil,
providing rally and support for the patient. Perhaps because of its strong associations with
the home, or perhaps simply because it was such a prolific dish, hominy was also broadly
recognized as a hospitality food, one served to any and all visitors.
Hominy was the principal nixtamalization foodway among Native groups in the
Eastern Woodlands, serving as the dietary backbone throughout the region, with
nixtamalizing steps perpetuated even after the common bean was widely adopted. To
explore this perseverance, we look at the social and cultural importance of the foodway,
beginning with the conservative emotional attachments granted to the culinary tastes of
native foodways that placed a premium on bitter, sour, even tart items, especially those
that included lye and wood ash. It is not only a comfort food, but also a special occasion
dish, not only a hospitality food, but a feasting food, one served to family, to friends, and

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to strangers alike. Thanks to this social element, even when nixtamalization was no
longer a critical nutritional practice, the activities and ingredients associated with it were
inseparable from the larger cultural and social role the foodway played.
Culinary ash will chemically accomplish what the lime does for corn during Meso-
American nixtamalization, and one study looked at information on the chemical
composition, functional properties, sensory quality and protein value of tortillas made
from the nixtamalization of maize using either lime or culinary ash. The Ca+, K+, Mg+,
Fe+, and Zn+ content of lime and wood ashes showed lime to be higher in Ca+ content
while wood ash contained more K+ and about 71% of the Ca+ content of lime. Both
contained relatively high levels of Mg+, Fe+ and Zn+, but more so in the wood ashes. The
level of reagent for nixtamalization was set at 0.8% of the maize weight. All other
processing conditions were kept constant. The pH of the cooking solution was 12.0 for
lime and 10.9 for wood ash. The moisture content of maize at 60 min of cooking was
45.8% for both treatments, however after 12 h of soaking, moisture level was 51.0% for
the lime treatment and only 46.8% for the ash treatment. Solids (2.4%) in the lime
cooking liquor were higher than in the wood ash liquor (1.0%). Chemical composition
changes were similar between treatments in masa and tortilla; however, both masa and
tortillas absorbed relatively high levels of all minerals including Fe+ and Zn+ from the
wood ash treatment. The different treatment influenced functional properties particularly
hardness and color. Tortilla characteristics were also similar. Protein quality of both
alkali cooked products was lower than that of raw corn, more so the product from the
wood ash treatment. Although some differences were observed in the sensory studies,
human subjects did not dislike the wood ash made tortillas.
Hominy, in one form or another, and nixtamalization of one kind or another, was
done by several native peoples across the Americas, for the Eastern Woodlands of North
America, the people developed a technique that looks a lot like the Meso-American
approach. First, dried flint maize kernels are soaked, usually overnight but for at least
several hours, in a solution made from either hardwood ashes themselves, or the water
collected after leaching through the ashes, essentially a Na+, K+ and OH- (lye) solution.
The kernels are ready when their hulls are either noticeably loosened or when the kernels
begin to change color, turning either light yellow or white, then the kernels are processed
by any combination of rinsing, rubbing, or grinding to remove the hulls as well as any
excess lye or wood ash, then the kernels are boiled in an earthenware pot, for one to ten
hours. Dishes fitting the general nixtamalizing description for hominy are referenced
frequently in ethnohistoric sources for the Eastern Woodlands. Such references that
describe processes for boiled maize, hulled maize, maize porridge, samp, sagamité, and
other maize dishes described as boiled with ash or lye but not named. Of course, while
there are considerable similarities, there are distinct, signature differences that identify
various group traditions. The foundation includes the basic steps of nixtamalization that
enable the transformation of maize into a nutritionally complete dietary staple, this is
some relatively complicated chemistry and it makes one wonder if there was a more
ancient tradition of processing corn that became culturally disseminated into successive
generations or if people were teaching one another how to do this thing during times of

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famine. It is interesting when humans pick up or develop a novel technology and how
quickly good ideas spread through populations. A lot of Europeans died from pellagra
when the conquistadors brought corn back to their homeland, they understood that corn
was food but they didn't share the cultural knowledge of how to process it into a
sustainable, nutritionally complete food.
Vinegar (French vyn egre-sour wine) is a sour liquid which is produced from the
fermentation of diluted alcohol products, its key ingredient is acetic acid, which can
range from 5% to 18%. Vinegar is as old as alcohol production and that makes it as old as
civilization itself. Sumerian tablets from 5000 BCE describe using vinegar as a cleaning
agent, as a condiment and as a food preservative, we find vinegar in Egyptian urns from
3000 BCE. Hippocrates spoke of using rue, thyme, pennyroyal, and lavender in aromatic
vinegar applications. Dioscórides wrote of using brine vinegar infused with Creten
thyme, barley groats, rue, and pennyroyal for driving out thick black humors. Known as
“poor man’s wine” (posca) in ancient times, vinegar was carried all over the world by
Roman legionnaires. Medieval physician Saladin Ferro suggested using a mixture of
rosewater and an aromatic acetum for washing the nose and faces of people who had the
plague in his treatise Concilium de Peste written in 1448. He also suggested sprinkling it
around the room. This was later simplified into an acetum containing roses, rue, and
wormwood4. It has a long history of being used in many cultures as a condiment and
preservative. Vinegar can be made from any fermentable or fermented liquid, including
malted barley, rice, and cider; however, as its name suggests, it was probably first made
from wine. It is not difficult to make, the easiest and most satisfying method to begin
with is mixing an unpasteurized vinegar like Bragg's apple cider vinegar, or another
vinegar starter culture, with some red wine and water. Any wine will work, It is easy to
start with a cheap store bought red wine and use the water to dilute the alcohol to
between 5%-9%. It is far more gratifying to ferment your own wine---and maybe some of
it gets made into vinegar. Place the diluted wine in a jar and add around 25 percent of that
volume of raw vinegar (if you have a liter of dilute wine, you are adding 250 ml of raw
vinegar). Once mixed with the diluted wine, the Acetobacter will transform the alcohol
into acetic acid. You need oxygen to make vinegar, so cover the jar with cheese cloth, a
paper towel or light towel and then secure it with a rubber band or string for protection. A
layer of primordial swamp-thing material, the vinegar mother, will form on top of the
liquid within 3 to 4 weeks. Once the mother is about 1/2 inch thick, about 4-6 weeks,
your vinegar is ready to go, strain the material through some cheesecloth and bottle it up.
This approach is a confidence builder, because it is pretty bulletproof. You can take your
next starter from this batch and keep the colony going in perpetuity. If you don’t have a
mother of vinegar after 4 to 6 weeks, something went wrong. There are a number of
reasons why it could fail: The culture in the original raw vinegar wasn’t alive, the
temperature was too cold or too hot, you forgot to dilute the wine, you aren't living right,
whatever... Toss it and try again with a new raw vinegar.
Vinegar can also be made fresh and from scratch with a double fermentation, in
the first fermentation, yeast breaks down the sugars in the absence of oxygen producing
alcohol and carbon dioxide, you are making a weak wine. In the second stage, the

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addition of oxygen enables Acetobacter to convert alcohol to acetic acid and that
produces your vinegar...the important distinction is that alcohol is produced in an
anaerobic environment and then vinegar in an aerobic environment. Over the centuries
and around the world, a wide variety of vinegars has been created, with their own colors
and flavors. These are used for culinary (pickling processes, vinaigrettes, salad dressing,
condiments), medicinal, agricultural, horticultural, and cleaning purposes. High-quality
vinegars, such as the balsamic vinegars prepared in Modena, Italy, continue to be
produced via a slow process of fermentation, typically aging for years in wood barrels.
When we talk about medicinal uses of vinegars, the historical uses were both
topical and internal, and we have to discuss the role that pH plays in extracting certain
medicinal constituents from plants, and especially alkaloids. Alkaloids are alkaline,
cyclic organic compounds containing nitrogen in their ring structure. While many
alkaloids are classified according to their molecular skeletons, classification based on
botanical origins is also common. They are generally water soluble under acidic
conditions and lipid soluble under neural and basic conditions. This is especially
important to remember--they dissolve in solution when protonated (acidic) and permeate
biological membranes when alkaline, or deprotonated. Alkaloids are primarily derived
from amino acids resulting in a wide variety of chemical structures, they can be found in
about 20% of plant species and their production, extraction and processing remain
significant economic centers for research and development, consider the economic
importance of the alkaloids nicotine, caffeine, cocaine and heroin. Alkaloid production
pathways have been manipulated genetically through natural and artificial selection of the
plants that contain them for millennia in order to achieve higher production levels of
alkaloids, much of what early humans learned about selective agriculture was through
attempting to maximize alkaloid production in different plant species. In 1819, the
German chemist Carl Meissner was the first to describe the active principles of these
plants as alkaline in character and elucidated an extraction technique. Atropine from
Atropa belladona, and hyoscyamine from Hyoscyamus niger were originally extracted in
the early 1830's followed by scopolamine. The use of the coca plant, Erythroxylum coca,
as a stimulant can also be traced to prehistoric times. Cocaine, the principal tropane
alkaloid of Erythroxylon coca was first isolated in 1860. Alkaloid extraction and
purification became central to the ethnopharmacological tradition and represents the
beginning of medicinal chemistry. Therapeutically, alkaloids are particularly well known
as anesthetics, cardioprotective, and anti-inflammatory agents. Well-known alkaloids
used in clinical settings include morphine, strychnine, quinine, ephedrine, and nicotine.
Contemporary medicine utilizes tons of atropine and scopolamine extracted from
genetically modified cultivars, while ever growing demand enhances new, chemical and
biotechnological methods of their manufacturing. In parallel, cocaine obtained from two
Erythroxylon species, which is of limited use in medicine because of very strong
addictive properties, became a subject of illicit manufacturing and trafficking of
“recreational drugs”, with socioeconomic and health endangering consequences on a
global scale.

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Vinegar is, in many ways, an ideal extraction solvent for many alkaloid containing
medicinal plants. The term "acetract" is often used to describe the products of this type of
extraction and is often most effective when the vinegar extraction is done alongside an
alcohol extraction. I have been wildcrafting Datura for 30 years in the desert southwest,
largely from the same location. The plant material is very consistent from year to year
and I have tested what I have made with both thin-layer chromatography and HPLC. I
don't need a lot; my clinic will use about a liter of tincture in a year. We collect it in
October or November, trimming peripheral leaves and stems from numerous plants, often
side by side with wild burros, we need 200 gms of dried material per liter of finished
product, which is about two large brown paper grocery bags of fresh material. I like to
freeze-dry the freshly collected and washed plant material, leaves and stems and the
occasional flower, avoiding seeds and seedpods. I do a 1:5 dilution in a 65% Ethanol/1%
Acetic acid solution (made by the liter by adding 200 ml of a 5% acetic acid apple cider
vinegar to 800 ml of 82% Ethanol (or, 684 ml of 95% Ethanol, 200 ml apple cider
vinegar and 116 ml water). I then let it sit in the dark for several weeks in a sealed 1-
gallon glass jug, agitating it when I think about it. When I have the time and I am
alchemically inspired, the incubation will be 42 days, beginning at a new moon and
ending at a full moon, then burning the marc and adding the ash back to the preparation
(this changes the pH-for better or worse, you get to decide). Adding 1% glycerin at the
end of the extraction mellows that high alcohol burn and makes the preparation more
tolerable. So, what have we made? A dreadful poison and a powerful medicine, the
leaves of Datura have a variable alkaloid concentration, it is generally highest right when
the earliest thornapples are splitting and releasing their seeds...recognizing that this is a
temperature and moisture-dependent phenomena, and so is alkaloid production. Dried
leaf material at its peak will have 0.9-1.0 mg/gm of atropine (some variable racemic
mixture of hyoscyamines) and 0.33 mg/gm scopolamine. We are using 200 gms of this
material to make each liter of tincture which will yield 0.18-0.20 mg/ml atropine and
0.066 mg/ml scopolamine.
Corydalis rhizoma, known as Yanhusuo and used as a therapeutic agent in
Traditional Chinese Medicine (TCM), is prepared from the dried tuber of Corydalis
yanhusuo and is reported to have the functions of activating blood, moving “Qi” (vital
energy) and relieving pain. It is used clinically as a botanical medicine for the treatment
of pain (especially heart pain), amenorrhea and dysmenorrhea, postpartum stasis and
obstruction. The chemical constituents of Yanhusuo have been isolated and identified as
tertiary and quaternary alkaloids, many of these alkaloids, like tetrahydropalmatine, exert
their effect by interfering with neurotransmitters in the central nervous system, others
have shown anti-tumor activity, anti-inflammatory and analgesic activity,
hepatoprotective effects, and antimalarial activity. Prior to their usage in clinics, crude
drugs are subjected to traditional Chinese processing techniques (PaoZhi) such as
cleaning, cutting and stir-baking with various other botanicals. Only processed slices of
Corydalis are used for decoctions in clinics and as raw material for pharmaceutical
manufacturing. There are four methods of preparation for Corydalis Rhizoma5, namely
dry-, vinegar-, wine- and salt-frying, and studies have pointed out that there are large

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differences in the alkaloid content between the processed products. As first documented
in Lei’s Treatise on Processing of Drugs (Leigong PaoZhi Lun) in the Tang Dynasty of
China (618–907 AD)6, Corydalis Rhizoma has been used mainly in vinegar and wine
processed form. The preparation deepens the external color of the tubers and is believed
to promote blood activation and pain relief. The difference between vinegar and wine
processing is given by the processing adjuvants, yellow wine and rice vinegar,
respectively. The function of yellow wine is to improve the pain relief effect, while rice
vinegar increases the efficacy of the herbal drug7. Previous reports showed that vinegar
processing can improve the analgesic effect of Yanhusuo and can also change the
pharmacokinetics of the main alkaloids8,9. With regard to the associated changes in
composition, only a few of the main compounds of Yanhusuo have been studied. For
example, vinegar processing was shown to cause an increase in tetrahydropalmatine and
a decrease in berberine and protopine9.
Some alkaloids are better presented in an alkaline solution, Betel nut or betel quid
chewing is an ancient human practice that involves chewing a mixture of areca nuts
together with slaked lime (CaOH) and betel leaves to achieve a physiologically euphoric
and stimulant effect. The practice is widespread throughout the world today but most
common in Asia, Polynesia and Sub-Saharan Africa. The oldest evidence of its use is
found in a burial pit in the Duyong Cave site of the Philippines, dating to around 4,600
years ago. Its diffusion is closely tied to the Neolithic expansion of the Austronesian
peoples, spreading through the Indo-Pacific during prehistoric times, reaching
Micronesia, Southern India, and Oceania 3500 years ago. It usually includes other
substances for flavoring and to freshen the breath, like coconut, dates, sugar, menthol,
saffron, cloves, aniseed, and cardamom. The areca nut itself can be replaced with or
chewed with tobacco, and the betel leaves can be excluded altogether or traded for
Mitrogyna leaves. The juice of the quid is not swallowed but spit out and tends to turn the
gums and teeth a bright red color.
Betel quid is used by as many as 600 million people in Asia and is the fourth most
widely used addictive substance in the world, after alcohol, caffeine, and nicotine. Yet, it
remains the most widely used and understudied substance of abuse in the modern world.
The components of the preparation, that is, the areca nuts, betel leaves and lime all hold
ancient positions in the culinary and medicinal landscape of the cultures of Asia. Piper
betle, commonly known as betel vine belongs to the family Piperaceae and is a popular
and ancient medicinal plant in Asia. The leaf is the most widely used and studied part of
the betel vine and it has a long history of use for oral health, it is rich in terpenes and
broadly anti-microbial and is beneficial for reducing bad breath, strengthening the gums,
preserving the teeth, and stimulating the digestive system. In traditional medicine
practices, betel leaves are also used for vaginal douching, as a gargle/mouthwash and
treatment for dental problems, headaches, arthritis, and joint pain. The boiled leaves are
used as an astringent lung tonic, reducing cough from atonic, swollen tissue. A very large
number of traditional applications of betel leaves are related to its antibacterial and
antifungal properties. Areca catechu is originally native to the Malaysian peninsula, but
its use has resulted in a long history of cultivation and naturalization throughout South

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and Southeast Asia. It requires a warm, humid, tropical climate to thrive and seeds are the
only means of propagation. The seeds have been widely used in traditional Chinese
medicine as an antiparasitic agent for thousands of years and both leaves and seeds are
used for the treatment of diarrhea, sunstroke, throat inflammations, edema, lumbago,
bronchial catarrh, and urinary disorders. The areca seed is often called a nut in the
marketplace, but it is more a berry than it is a nut, it is commercially available in dried,
cured, and fresh forms. When the husk of the fresh fruit is green, the nut inside is soft
enough to be cut with a typical knife. In the ripe fruit, the husk becomes yellow or
orange, and as it dries, the fruit inside hardens to a wood-like consistency. At that stage,
the areca nut can only be sliced using a special scissor-like cutter that is made for the
purpose. The major alkaloids in betel nut are arecoline, arecaidine, guvacine,
isoguvacine, and guvacoline. Arecaidine and guvacine are each hydrolyzed from
arecoline and guvacoline, respectively, and the relative concentrations of the alkaloids
change with the age of the plant, and the age of the seeds, total alkaloid content can range
from 2.86-9.91 mg/gm dry weight10. Tannins present in betel nut are mainly
proanthocyanidins along with catechins and arecatannin. The alkaloids are muscarinic
receptor agonists, with some nicotinic acid receptor activity exhibited by arecoline and
GABA uptake inhibition from arecaidine. This very ancient and ritualized activity
involving the simultaneous consumption of two plants and a mineral that is used
regularly by 20% of the world's population is a complex arrangement of psychotropic
constituents. It is a decent anti-parasitic, with particularly good effect on tapeworm
infestations, the mechanism of action is as a paralytic, the same mechanism as the
organophosphate insecticides, overstimulation of acetylcholine receptors. Which can also
cause the whole cholinergic cascade in humans, mostly it doesn't, each constituent adjusts
and modifies the effects of the others so that the cascade is blunted, distorted and
transformed. In interesting and subtle ways, people are using this agent to surf across
their acetylcholine receptors and alter their perception of the world in a predictable and
addictive manner, extracting drops of euphoria through washes of physiologic response.
The long and the short of the process boils down to a stimulating effect on the mind,
increased salivation, diarrhea, and watering eyes. Studies show that consumption of the
betel nut quid improves recovery time from ethanol consumption, with a notably
shortened duration of ethanol's vestibular effects, it has been shown to improve cognitive
function and memory in dementia and Alzheimer's patients and reverses scopolamine-
induced memory loss and learning impairment11.
The pendulum swings to the extremes as it pertains to how our body responds to
shifting pH, yet, our physiology is hardwired to hold our internal milieu to a pH range of
7.0-7.4. Through an intricate network of weak acid and base buffering systems into the
active work of our kidneys and lungs, we do a pretty amazing job of maintaining that
neutral pH. As we introduce certain items into the body, we affect this pH buffering
system, and with a little forethought, we can improve our therapeutic interventions. A salt
water wash through a neti-pot can be gloriously effective at reducing sinus congestion,
adding a pinch of baking soda allows that wash to also neutralize histamines and
recondition the lining of the sinus passageway. A hypersal nebulizer solution can be very

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helpful for ling congestion, adding a little baking soda will render the secretions of the
lung easier to move and less sticky.

References:
1. Siyuan S, Tong L, Liu R. Corn Phytochemicals and Their Health Benefits. Food Sci.
Hum. Wellness. 2018;7:185–195.
2. Mason JB, Gibson N, Kodicek E. The Chemical Nature of the Bound Nicotinic Acid in
Wheat Bran: Studies of Nicotinic Acid Containing Macromolecules. Br. J. Nutr.
1973;30:297.
2.5. Briggs, Rachel V. 2014. The Hominy Foodway in the Historic Native Eastern
Woodlands. Presented at the 71st Annual Southeastern Archaeology Conference,
November 12-15. Greenville, South Carolina.
3. Martin W. J. (1900). Therapeutical and Pharmaceutical Notes. The Journal of
comparative medicine and veterinary archives, 21(8), 485–488.
4. Hoffelt, Stephany. https://domestic-medicine.com/2013/01/17/acetums/ Stephany
passed in January of 2025, she leaves behind her much cherished family and a legacy of
historical syntheses and rabbit holes that she documented on her blog at Domestic-
medicine.com--her presence is greatly missed in the herbal community as someone who
had strong opinions and a reference list to back up those opinions. Rest in Peace,
Stephany, thank you for helping make this world a better place.
5. Bensky and Gamble, Chinese Materia Medica, Eastland Press, Seattle, WA 1992,
pg.307.
6.Dou Z.Y., Li K.F., Wang P., Cao L. Effect of wine and vinegar processing of rhizoma
corydalis on the tissue distribution of tetrahydropalmatine, protopine and
dehydrocorydaline in rats. Molecules. 2012;17:951–970.
7. Zhang X., Li T., Mao C. Analgesic and anti-inflammatory effects of different kinds of
Corydalis yanhusuo. Shizhen Guoyi Guoyao. 2009;20:449–450.
8. Chen X., Lu T., Zhang X.H. Determination of tetrahydropalmatine of different
processed products of rhizoma corydalis by HPLC. Chin. Traditional Patent Med.
2003;25:726–727.
9. Zhang X.Y., Zhang X.D., Liu X.P. Effect of vinegar processing on contents of 3
alkaloids in rhizoma Corydalis yanhusuo. J. Nanjing Univ. Traditional Chin. Med.
2008;24:410–411.
10. Chen X, He Y, Deng Y (2021). "Chemical Composition, Pharmacological, and
Toxicological Effects of Betel Nut". Evidence-Based Complementary and Alternative
Medicine. 2021: 1808081.
11. Yu-Jie Liu, Wei Peng, Mei-Bian Hu, Min Xu & Chun-Jie Wu (2016) The
pharmacology, toxicology and potential applications of arecoline: a review,
Pharmaceutical Biology, 54:11, 2753-2760.

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THE FOOT: THE NATURAL HISTORY OF

AN APPENDAGE
DR. KENNETH PROEFROCK

The human foot contains 26 bones, 33 joints, and over 100 muscles, tendons, and
ligaments, all wrapped together in layers of fascia and working with a coordinated
effort to support and move the body--allowing for a range of movements that include
the delicate balance required for tiptoeing to the powerful thrust needed for sprinting

THE ARCHES OF THE FOOT REPRESENT AN ARCHITECTURAL MARVEL, ABSORBING AND Biotensegrity: muscles, bones, fascia, ligaments and tendons are made
DISTRIBUTING THE IMPACT OF EACH STEP, REDUCING STRESS ON THE REST OF THE
BODY AND MAINTAINING OVERALL STABILITY AND BALANCE strong by the union of tensioned and compressed parts.

THE BODY IS NOT A COMPRESSED ARCHITECTURE OF BONES STACKED ON

TOP OF ONE ANOTHER-IT IS A SUSPENSION—BEGINNING WITH THE THE ARCHES DETERMINE BALANCE AND POSTURE
SUSPENDED ARCHES OF THE FEET PROPRIOCEPTION BEGINS IN THE FEET

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THE FOOT IS DIVIDED INTO THREE ANATOMICAL REGIONS

THE ANATOMICAL HINDFOOT THE ANATOMICAL MID-FOOT

The hindfoot consists of the Calcaneus and the Talus bones, whose articulation allows for
inversion and eversion of the foot and ankle. The Midfoot consists of 5 bones: the Navicular, Cuboid, Medial,
Intermediate, and Lateral Cuneiforms. The bones of the midfoot help to
form the arch of the foot, and their function is to transmit and reduce
The Talus is one of the few bones in the body not connected by ligaments to other bones,
forces while allowing the foot to accommodate uneven ground surfaces.
and almost its entire surface is covered by cartilage. Its primary function is to transfer force
through the heel as it forms the lower part of the ankle joint. The Navicular bone is irregular in shape and referred to as the keystone of
the medial arch of the foot. Due to the location of the Navicular at the
The Calcaneus bone is also known as the heel bone and serves as a connection point for the peak of the arch of the foot, it is susceptible to stress fractures and can be
achilles tendon and the plantar fascia. It is a very strong weight-bearing bone and takes a poor at healing due to its limited blood supply.
high-force incident like a fall or car crash to break.
The Cuboid bone is roughly cubical in structure hence its name, and it is
located on the outside of the midfoot. It helps to provide stability to the
midfoot.

The Cuneiform bones are 3 wedge-shaped bones that form the transverse
arch of the foot. They have numerous muscular attachments, such as the
Tibialis Anterior, Peroneal Longus, Posterior Tibial Tendon, and Flexor
Hallucis Brevis.

THE ANATOMICAL FOREFOOT HARD CONNECTIVE TISSUES OF THE FEET

The forefoot consists of 19 bones; 5 metatarsal bones Cartilage: Shiny and smooth, cartilage allows smooth movement where two
and 14 phalanges. The big toe has 2 phalanges bones, bones come in contact with each other, this is the interface that is most subject
while the remaining four have 3 phalanges each. to arthritic changes. It is often the compression of cartilage that leads to
increased play in the joint and then increased deterioration of the cartilage
The 1st metatarsal is the shortest and thickest of the with spurring of bones.
metatarsals, and it is designed to take up to 40% of
your body weight in standing, which rises to 70% Ligaments: Ligaments are fascial structures that are strong rope-like tissues
when walking. that connect bones to other bones, stabilize tendon positions and provide
The 2nd metatarsal is often the longest, with the 3- stability to the joints. The plantar fascia is the longest ligamentous structure in
5th metatarsals becoming shorter than the other, but the foot, originating at the calcaneus and continuing along the bottom surface
this varies depending on foot type, and they assist of the foot to the forefoot. It is responsible for the elasticity of the arches of
with balance when walking and running. the foot and provides shock absorption. Plantar fasciitis happens when
repetitive micro tears occur in the plantar fascia from overuse. Ankle sprains,
The Phalanges provide attachment points to allow the the most commonly reported injury to the foot and ankle area, involve
toes to bend and extend while also assisting with ligament strain, and usually occur to the talo-fibular ligament and the
balance. calcaneo-fibular ligament.

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Ligament Remodeling SOFT CONNECTIVE TISSUES OF THE FOOT

"Ligaments, or any soft tissue, when put under
even a moderate degree of tension, if that tension Muscles: Muscles are fibrous tissue capable of contracting to cause body
is unremitting, will elongate by the addition of movement. There are 20 muscles in the foot and these are classified as intrinsic or
new material; on the contrary, when ligaments, or extrinsic. The intrinsic muscles are those located in the foot and are responsible
rather soft tissues, remain uninterruptedly in a for toe movement. The extrinsic muscles are located outside the foot in the lower
loose or lax state, they will gradually shorten, as leg. The gastrocnemius or calf muscle is the largest of these and assists with
the effete material is removed, until they come to movement of the foot. Muscle strains occur usually from overuse of the muscle in
maintain the same relation to the bony structures which the muscle is stretched without being properly warmed up.
with which they are united that they did before Tendons: Tendons are soft tissue that connects muscles to bones to provide
their shortening. Nature never wastes her time and support. The Achilles tendon, also called the heel cord, is the largest and strongest
material in maintaining a muscle or ligament at its tendon in the body. Located on the back of the lower leg it wraps around the
original length when the distance between their calcaneus.
points of origin and insertion is for any Bursae: Bursae are small fluid filled sacs that decrease friction between tendons
considerable time, without interruption, shortened” and bone or skin. Bursae contain special cells called synovial cells that secrete a
Henry Gassett Davis 1867 lubricating fluid.

TENDONS/TENDINITIS/TENDINOPATHY FASCIA

Tendons are the fascial structures that connect Fascia is, literally, the biological fabric that holds our body together, a three-
muscle to bone, generally a pully system with the dimensional spider web of fibrous, gluey, and wet proteins that acts like a
tendon sliding through a lubricated synovial bracing and organizing scaffold for the physical form.
sheath. Understanding fascia is essential to understanding the dance between static and
dynamic bodily processes, between the experience of pain and that of comfort,
Tendinitis involves a strain and swelling of the it is crucial to physical performance, central to recovery from injury and
tendinous structure, tendinopathy happens when disability, and an ever-present participant in our daily quality of life.
the inflamed tendon ‘sticks’ or heals to the wall of
the sheath. Tenosynovitis is an inflammation of
Fascia is one single, vastly interconnected, biomechanical regulatory system
the synovial sheath.
with millions of tiny nerves moving in and out of adjacent sheets of fascial
A condition that is very amenable to topical material, into and out of contained compartments of fluid within muscles,
application of antispasmodic agents, stretching organs and skin. Not only does it represent a structurally critical component of
therapy, and internal use of inflammation the physical form, it also acts to transmit information and resources throughout
resolving botanicals like Alpinia, Zingiber, the system, often faster and more deliberately than other bodily communication
Lobelia. systems.

Fascia connects us to every other aspect of ourselves

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IS THE INTERSTITIUM REALLY A NEW ORGAN?

A 2018 STUDY CONFIRMED THAT THE SPACES BETWEEN CELLS ARE FLUID-FILLED
EXTRACELLULAR MATRIX (ECM): A COMPLEX MIXTURE OF
BENIAS ET AL., SCIENTIFIC REPORTS, SECRETED MACROMOLECULES THAT LUBRICATE TISSUES

Frozen human bile duct tissue imaged by

fluorescence microscopy demonstrates the net-
like pattern in the connective tissue of the
interstitium.

THE EXTRACELLULAR MATRIX CONTAINS THREE CLASSES OF GLYCOSAMINOGLYCANS (GAGS)

MOLECULES:
"unbranched polysaccharide chains composed
of repeating disaccharide units"
• usually sulfated
• highly negatively charged
• forms a gel that attracts Na+, water and
swells
• Can occupy a lot of space/mass
• resists compression
• synthesized predominantly in the Golgi
apparatus
– Types of glycosaminoglycans:
• hyaluron (hyaluronic acid)
• chondroitin sulfate and dermatan sulfate
• heparan sulfate and heparin
• keratan sulfate

Hyaluronic acid: An extremely common polymer found in nature Hyaluronic Acid Hydrogel
The largest GAG, makes up an enormous proportion of the basal lamina of mammalian tissues. Provides a matrix for the
A linear polysaccharide consisting of D-glucuronic acid and N-acetyl-D-glucosamine linked by Beta(1,3) and
Beta(1,4) glycosidic linkages. migration of remodeling cells
Distinguished from the other glycosaminoglycans as it is free from covalent links to protein and sulphate groups.
Consider the addition of PRP,
Has been demonstrated to be important to tissue functions such as tissue hydration, lubrication, solute transport,
peptides—TB4, BPC,
cell migration, cell function and differentiation. Neurotrophic growth factors,
Dietary sources of hyaluronic acid include bone broth/bone ends and mushrooms. procaine
Ultrasound guided injection
directly around the site of
repair
5-7.5 mg/ml concentration

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Raghavan Page 14

Author Manuscript
Author Manuscript
THIXOTROPY TREATMENT
Ida Rolf proposed the theory that connective tissue is a colloid
substance in which the ground substance can be influenced by
the application of energy (heat or mechanical pressure) to

Author Manuscript
change its aggregate form from a more dense “gel” state to a
more fluid “sol” state.
Typical examples of this are common gelatin or butter, which
get softer by heating or application of mechanical pressure. This
gel-to-sol transformation, also called thixotropy (Juhan 1987),
has in fact been demonstrated in connective tissues as a result of Figure 6.

Author Manuscript
the application of mechanical stress as well as temperature The hyaluronan hypothesis. The dark patches represent aggregates of hyaluronan. Injection
Figure 6.
differential therapy (alternating hot and cold). ofThe
the hyaluronan
enzyme hyaluronidase can potentially hydrolyze the hyaluronan deposits, and restore

Author Manuscript
hypothesis. The dark patches represent aggregates of hyaluronan. Injection
sliding
of the of the muscle
enzyme fibers and
hyaluronidase fascicles.
can potentially hydrolyze the hyaluronan deposits, and restore
Rigor mortis vs deep sleep sliding of the muscle fibers and fascicles.
Courtesy of Dr. Susie Kwon, MD, NY, New York.
Courtesy of Dr. Susie Kwon, MD, NY, New York.

Author Manuscript
Author Manuscript

Phys Med Rehabil Clin N Am. Author manuscript; available in PMC 2019 August 01.

Dystonia Buhren et al. Eur J Med Res (2016) 21:5

DOI 10.1186/s40001-016-0201-5
European Journal
of Medical Research
Phys Med Rehabil Clin N Am. Author manuscript; available in PMC 2019 August 01.
REVIEW Open Access

Hyaluronidase: from clinical applications

to molecular and cellular mechanisms
Bettina Alexandra Buhren1, Holger Schrumpf1, Norman-Philipp Hoff1, Edwin Bölke2*, Said Hilton3
and Peter Arne Gerber1

Abstract
Over the past 60 years, hyaluronidase has been successfully utilized in ophthalmic surgery and is now being imple-
mented in dermatosurgery as well as in other surgical disciplines. The enzyme is considered a “spreading factor”
as it decomplexes hyaluronic acid (also called hyaluronan, HA), an essential component of the extracellular matrix
(ECM). When applied as an adjuvant, hyaluronidase enhances the diffusion capacity and bioavailability of injected
drugs. Therefore, the enzyme has been used as a local adjuvant to increase the diffusion capacity of local anesthetics,
increasing the analgesic efficacy, and the anesthetized area particularly in the first minutes following injection, result-
ing in diminished intra- and postoperative pain. In aesthetic medicine, the off-label use of hyaluronidase is consid-
ered the gold standard for the management of HA-filler-associated complications. Here, we review the clinical use,
underlying biological mechanisms, and future directions for the application of hyaluronidase in surgical and aesthetic
medicine.
Keywords: Hyaluronidase, Hyaluronic acid, Hyaluronan, Filler, Dermatosurgery, Aesthetic dermatology, Adjuvant,
Spreading effect, Diffusion promotor

Background capacity and, therefore, contributes to the viscoelastic

Regulation of hyaluronan (HA) metabolism properties of the skin.
The extracellular matrix (ECM) of the skin consists of a Approximately 50 % of all HA in the body is found in
complex and dynamic network of macromolecules. In skin tissue and with typical concentrations ranging from
addition to providing the structural framework, the ECM 0.5 to 1 mg/g in the dermis [3]. Unfortunately, HA con-
plays an important role in regulating various cellular tent decreases with age, resulting in loss of skin mois-
mechanisms including proliferation, adhesion, migra- ture and laxity, both characteristic features of aging skin.
tion, and gene regulation [1]. The main components of Therefore, the cosmetic injection of HA-containing der-
the ECM are the fibrous proteins collagen and elastin, mal fillers has evolved as one of the key strategies in skin
as well as, the proteoglycans (PGs) to which character- rejuvenation.
istic glycosaminoglycan (GAG) chains are attached. The Immunohistochemical analyses of biotinylated HA-
most common GAG in the dermis is hyaluronic acid (also binding proteins demonstrated that HA is not only syn-
called hyaluronan) [2]. Hyaluronan (HA) is a linear gly- thesized by dermal fibroblasts but also by epidermal
cosaminoglycan disaccharide composed of alternating keratinocytes [4]. HA is synthesized by plasma mem-
units of -acteyl--glycosamine and -glucuronic acid brane-bound enzymes, the HA synthase enzymes -1, -2,
via alternating β-1.4 and β-1.3 glycosidic bonds [3]. Since and -3 (HAS1-3), that extrude HA directly into the extra-
it is extremely hydrophilic, HA has a high hydration cellular space. HAS1-3 exhibit distinct enzymatic proper-
ties and synthesize HA chains of various lengths [5].
The turnover of HA depends on location and has an
*Correspondence: boelke@med.uni-duesseldorf.de approximate half-life in the skin of only one day or less.
2
Department of Radiation Oncology, Medical Faculty, HA is degraded into smaller HA fragments (HAF) by hya-
Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
Full list of author information is available at the end of the article
luronidases (HYAL) which hydrolyze the disaccharides at

© 2016 Buhren et al. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License
(http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium,
provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/
publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Polygonatum multiflorum Asparagus racemosa-Shatavari

Solomon’s Seal Shatavari is a Sanskrit term that can be translated as “who
possesses a hundred roots”, or “husbands”. It is considered
Solomon’s seal is a yin tonic in Traditional Chinese
both a general tonic and a female reproductive tonic. In
Medicine that is nourishing, lubricating and moisturizing
Ayurvedic medicine, it is known as the “Queen of herbs”,
to the connective tissues of the body. It is considered
because it is a primary rejuvenative tonic for females, in the
specifically nutritive and moisturizing to tendons and
same way Withania is for males and it is revered for its ability
joints and seems to help the tendons and ligaments adjust
to promote love and devotion. Shatavari reduces internal heat
to variable tension on the structure, tightening when
and improves lubrication of the muscules, joints and the mind.
loose and loosening when tight. This is a specific agent
The major active constituents of A. racemosus are steroidal
that helps connective tissue structures and bones
saponins (Shatavarins I-IV) that are present in the roots and are
accommodate to the forces that are placed upon them. I
helpful in reducing inflammatory states in the fascia and
use it as a powder, 100-250 mg 2-3 times a day or as a
connective tissues. Dosage is 1-4 grams per day.
tincture, 15-30 drops 3 times a day.
Combines well with comfrey, teasel and/or horsetail.

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Verbascum thlaspi-Mullein Tilia platyphylla-Linden Flower

This can be nice as a nourishing herbal infusion, though, it Flowering plant in the family Malvaceae (Tiliaceae).
is good to reduce the amount of herb to 15 grams/liter of Slimy, soothing, demulcent as a cold decoction
water as it gets very mucilaginous, the root is especially Diaphoretic and vasodilating as a hot decoction
rich in minerals and not quite as mucilaginous as the stalk
or leaves. Historically used to soothe nerves and treat health problems
associated with anxiety… its calming nervine, antispasmodic, and
Mullein leaf is mostly thought of as a respiratory herb, both helpful circulatory properties are used to help to ease spasms and
the root and leaf are a good musculoskeletal remedy. Like cramps that contribute to headaches, tight muscles, and migraines
Solomon’s Seal and Shatavari, it seems to have a as well as menstrual cramps
lubricating and hydrating effect on synovial membranes and
fascia. It tastes good and lends itself nicely to a strong herbal infusion-30
gms in a liter of water, a cold decoction of the flower makes a
A liter of root infusion daily, mixes well with Tilia dependable mucilage.

Actaea (Cimicifuga) racemosa-

Black Cohosh Comfrey-Symphytum officinalis
Has a history of use as an anti-inflammatory and antispasmodic Comfrey possesses a remarkable ability to facilitate rapid
with action on the muscles and fascia with a relaxing, blood flow healing of virtually all tissues.
encouraging impact for joints and tendons. It works well in It will help with the healing of fascia, broken bones, torn
conjunction with Lobelia and Valerian. muscles, tendons or ligaments, and just about anything
else. The presence of potentially liver toxic pyrrolizidine
It has a specific homeopathic indication for relieving neck pain alkaloids in comfrey have prompted some people to avoid its
and cramps caused by bad posture and aggravated by cold and use. While there is still much debate on whether comfrey use
humidity. is likely to cause liver damage, very good herbalists have
opinions on both sides of the debate. I urge you, if you choose
Doses of 15-20 drops of tincture 3-4 times a day seem helpful to to use comfrey, to look at the points presented on either side
restore damaged tissues and build durable fascial connections. and make your own educated decision. I do not think that,
taken in small doses and in limited duration, the use of
comfrey in healing injuries poses more risk than the benefits

FEET ARE AN ENDLESS SOURCE OF FASCINATION EARLIEST ARTISTIC RENDERING OF THE HUMAN HAND AND FOOT

169,000-226,000 BP, found at

Fossil Hot Spring at Quesang,
Tibet—
Believed to be intentionally made
by two children who were track-
making on the soft travertine
which later hardened.

500-year-old feet
petroglyphs from
Newspaper rock,
Utah

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SACRED FEET CHARAN SPARSH

In Hindu culture, the act of touching the feet of elders, teachers, and deities
holds deep spiritual, cultural, and emotional significance. Known as
The concept of Sacred feet is deeply rooted in various spiritual traditions “Charan Sparsh,” this sacred gesture is much more than just a physical act;
it embodies respect, gratitude, humility, and reverence. By bowing down
across the world, including the Hindy paths of Vaishnavism, Purana,
and touching the feet of those who have imparted wisdom, love, and
Shaktism, and Shaivism. In these contexts, Sacred feet represent the divine, guidance in our lives, we acknowledge their invaluable role in shaping our
embodying holiness, purity, and a pathway to salvation. thoughts, values, and actions.
They are the part of us that connect us to the Earth, they are also the witness
of our journey through life. This practice not only honors the life experiences of our elders but also
allows us to symbolically receive their blessings and divine energy. It
reminds us of the importance of selflessness, submission, and surrender to
the wisdom of those who are our mentors, guardians, and spiritual guides.
Rooted in ancient Hindu philosophy, the act of “Charan Sparsh” is
believed to be an invitation to spiritual growth and enlightenment. It
signifies that we remain humble, open to learning, and committed to
nurturing the timeless traditions of respect and love.

FOOT WASHING LARREA TRIDENTATA-CREOSOTE BUSH

The leaves are ground into a powdered extract that can be brewed into
Washing another’s feet is a significant ritual act in most of the tea, which was the form used by Native Americans for centuries to treat
major religious systems of the world, it is an act that symbolizes various conditions such as respiratory illness, chickenpox, snakebite and
purification and respect for the divine, a cleansing practice that arthritis pain, commonly drank as a tea and used as a foot bath.
takes place before worship and reflects humility. It is Multiple active ingredients, the most prominent being
exemplified by Krishna's act towards the Brahmans when he nordihydroguaiaretic acid (NDGA), which has potent antioxidant
washed their feet , Rasik Murar’s comparable gesture with the properties.
saints, and Christ’s washing of his disciples’ feet before the last NDGA is found in many plant species and has been used as a food additive
supper. Washing someone’s feet serves as a profound in low concentrations.
expression of respect and devotion in spiritual practices. The best and safest use is as a tea administered before
meals. Disrupts biofilm structures. Antifungal
Can be hepatotoxic in excessive dosages.

THERAPEUTIC FOOT BATHS Hydrotherapy

In Traditional Chinese Medicine, the Aromatic herbs have long been used for therapeutic
human foot is said to be the root of the body, foot and body baths, often minerals like Epsom salts and Contrast Hydrotherapy, a recent study published in the
its connection with the Earth, a connection sodium bicarbonate are added for greater effect, and journal Frontiers in Immunology found that contrast
that directly feeds one’s essence, Jing, which these kinds of foot baths have been used for hundreds of hydrotherapy significantly improved fatigue, pain, spasticity,
years with the idea that we are medicating the whole and quality of life in patients with neuroinflammation. The
is stored in the kidneys and relates to
body through the feet
longevity and vitality. hot-cold contrast was found to have a positive effect on
The following recipe for a foot bath has been shown
The foot is the beginning of the three yin to be very effective at reducing hypertension: immune function, reducing inflammation and promoting a
meridians (liver, spleen, and kidney) and the 15g Uncaria 20g Chrysanthemum 20g, Prunella vulgaris healthier immune response, significantly improving balance,
end of the three yang meridians (stomach, 30g Schisandra, 10g, Eucommia 15g Angelica 25g of gait and nerve regeneration.
gallbladder, and bladder). Apocynum and 20g of Cassia apocynum, the preparation
Simply using alternating hot and cold is said to calm the liver, relieve wind, clear heat and
The 2023 paper showed that even 5-minute cold immersion
foot baths can be wildly helpful—this type of promote blood circulation, It works, it smells pleasant
and unique, sitting with your feet in a hot bath is bound therapy alone is associated with a facilitated positive affect
contrast hydrotherapy will move blood into
and back out of areas of the body that are to lower your blood pressure, this preparation may have and reduced negative affect, which are linked to changes in
congested due to inflammation.
an effect for 12-24 hours. connectivity between large-scale brain networks.

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WET SHEET PACK WET SOCKS TREATMENT

This is essentially a warming compress in the form of socks, the treatment

Patient gets in a very warm bathtub for at least 15 acts to reflexively increase circulation throughout the body. It has a sedating
action and many patients report that they sleep much better during the
minutes, treatment. It is effective for pain relief and increases the tissue healing
Consuming hot tea (ginger) improves response.
effectiveness. Supplies:
1 pair white cotton socks
Upon arising from the bath, the patient is bundled
1 pair thick wool socks
in a large bath towel and a wool blanket.
Towel (or two)
The heat from the bath and tea are both preserved
Warm bath or warm foot bath
and patient will often develop and maintain a
Take a pair of cotton socks and soak them completely with cold water. Be
fever of 102-1030 F sure to wring the socks out thoroughly so they do not drip.
They can be kept in this state for several hours, if Place cold wet socks on feet. Cover with thick dry wool socks. Go directly to
warranted bed. Avoid getting chilled.
Keep the socks on overnight. You will find that the wet cotton socks will be
dry in the morning.

FOOTBINDING
CINDERELLA AND A WHOLE LOT OF CULTURAL ISSUES AND FEET

French author Charles Perrault is often called the

“father of the fairy tale” for his well known tales
such as “Little Red Riding Hood,” “Puss in Boots,”
“Sleeping Beauty,” and “Cinderella.” Cinderella is a
famous folk tale, a story that has been passed down
for many generations, about a young woman trying
to overcome the cruelty of some of her family.
There are numerous different versions of the story,
with historical roots in places as far apart as China
and Italy. Perrault’s version circa 1697 is the one
made famous by Disney in 1950. He was the first to
include the famous pumpkin, fairy godmother, and
the glass slipper.

SERIAL CASTING PISCIDIA ERYTHRINA-JAMAICAN DOGWOOD

Traditionally used for spasm and associated pain of uterus and
Foot binding principles applied skeletal muscle. It is indicated in insomnia, dysmenorrhea with
to congenital deformities. associated nervous and/or musculoskeletal tension, migraine
headaches and neuralgia.
Billie Cusick at Progressive It is very useful for pain, general distress, inflammatory fever,
Gaitways in Telluride, CO does rheumatism, spasmodic cough, bronchitis, intestinal colic, gall-
a series of training programs stone colic, renal colic, labor pains, facial neuralgia, ovarian
that are excellent. neuralgia, sleeplessness, delirium, and toothache. Eases muscle
She uses Turtle braces—heat spasms and cramps, especially of nervous origin.
moldable material that has a The isoflavonoid (rotenone) is antispasmodic and a cardiac
zipper!! sedative, it is responsible for the plant’s toxicity.
Dosage is 1-2 grams dried bark as a powder or tea daily in
divided doses.

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PEDICULARIS SPP MITROGYNA SPECIOSA-KRATOM

Members of the Pedicularis genus are varyingly called Kratom is a tropical tree in the coffee family (Rubiaceae), it is
"Lousewort” or "Wood Betony". The genus name, native to Southeast Asia and its foliage is used for the
"Pedicularis", was established in 1753 by Linnaeus, and is treatment of diarrhea, the improvement of mood and affect
and as a pain reliever. There are more than 40 compounds in
derived from the Latin "pediculus", or "louse".
kratom leaves, including Raubasine, an anxiety relieving
Pedicularis species are used medicinally as a skeletal muscle alkaloid also found in Rauwolfia serpentina and
relaxer and general sedative. corynantheidine, also found in Corynanthe yohimbe.
tryptamine
The flowers are often made into a tea or smoked. Extracts of The chemical structure of the mitragynine alkaloids,
the flowers have a strong relaxing effect when smoked. When mitragynine, mitraphylline, 7-hydroxymitragynine and
used in a smoking blend, they add a nice flavor and relaxing mitragynine pseudoindoxyl. Incorporate a tryptamine nucleus
which is likely responsible for their effect on the serotonin and
effect.
adrenergic systems. Mitragynine, is considered to be a strong
Oral Dosage: 100-300 mg 3-4 times a day analgesic.
Tincture—10-30 drops four times a day Lower dosages, 400-1200 mg, have a stimulating effect, 2-3 gm
doses are more overtly pain relieving.

Dicentra Formosa-Western or Pacific Bleeding Heart

HYDROPHILIC CREAMS
Botanical cousin to the papaveraceae Hydrophilic creams are fun and easy to make, I usually custom make them
for specific patient problems, most of the time for musculoskeletal and
Historically used topically for tooth pain neurological pain syndromes. We start with a base of 1 liter of macadamia
nut oil, make it hot, I like a double boiler, add 300 gms of beeswax and
Used by the Eclectics and Physiomedicalists of the 1800’s for 175 gms of emulsifying wax (cetearyl alcohol). Put it in your counter top
cancerous conditions and neuropathic pain mixer at top speed and let a whipping frenzy begin, I have had wonderful
successes with peripheral neuropathy and CRPS (complex regional pain
Fresh plant tincture—root and leaf--a narcotic-analgesic for pain syndrome) with the following cream recipe:
and central nervous system disorders.The root is the strongest
1 oz. Aconitum napellus tincture
part, and a tincture of the root has been used for sore teeth, lost
fillings, or mouth trauma. Any part of the plant can be applied 1 oz. Veratrum viride tincture
locally to painful sprains, bruises, or contusions. 1/2 oz. DMSO
Dose is 1-2 ml of 1:3 fresh plant tincture 3 times a day or 2-3
Mix into 100 gms cream base very slowly while stirring with a wooden
grams of root 2-3 times a day
tongue depressor.

BACLOFEN
PENTOXIFYLLINE

Baclofen, β-(4-chlorophenyl)-γ-aminobutyric acid, holds a Pentoxifylline (Trental) is a derivative of dimethylxanthine that

unique position in neuroscience, remaining the only U.S. Food decreases the viscosity of the blood, enhancing oxygen delivery
and Drug Administration (FDA) approved GABA-B agonist. to tissues, particularly in patients with chronic peripheral arterial
While intended to be a more brain penetrant, i.e, ability to disease. Topical formulations of pentoxifylline enable localized
cross the blood-brain barrier (BBB), version of GABA (γ- treatment, which has the advantage of reduced systemic side
aminobutyric acid) for the potential treatment of epilepsy, effects compared with oral administration; this is especially
baclofen’s highly efficacious muscle relaxant properties led to beneficial for patients who are unable to tolerate the oral form or
its approval, as a racemate, for the treatment of spasticity. those requiring targeted therapy. The topical cream (3-5%) in
Interestingly, baclofen received FDA approval before its hydrophilic base has been used for decades in diabetic wound
receptor, GABA-B, was discovered and its exact mechanism of care, and is commonly applied in the management of peripheral
action was known. We find that a topical preparation with 3%
baclofen in a hydrophilic base is very helpful for conditions of
vascular diseases such as intermittent claudication. We find that
neuropathy and spasticity, it can be applied three times a day. a 3% cream with 3% piroxicam and 3% baclofen to be very
helpful topically for spasticity and arthritic pains.

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CAPSAICIN
PIROXICAM
Capsaicin, a member of the vanilloid family, binds as an agonist to
Piroxicam is a benzothiazine and monocarboxylic acid amide vanilloid receptor subtype 1, an ion channel trans-membrane
and a non-steroidal anti-inflammatory drug of the oxicam class, receptor in the sensory pathway. This receptor is also stimulated
it is used to relieve pain and works by preventing the by temperature changes, physical abrasion, pH changes, and
production of endogenous prostaglandins involved in the endogenous lipids. When activated, it starts a neural depolarization
mediation of pain, stiffness, tenderness and swelling. It has a role cascade that allows the influx of sodium and calcium ions.
as an analgesic, a cyclooxygenase 1 inhibitor, a non-steroidal Capsaicin reduces pain transmission by desensitizing the sensory
anti-inflammatory drug, a prostaglandin-endoperoxide synthase afferent axons. This phenomenon occurs due to a release of
inhibitor and an antirheumatic drug. It is fat-soluble and lends substance P triggered by the calcium influx, causing the initial burn,
itself to topical application in situations where you need more but after repeated application, capsaicin depletes the neuron of
specific anti-inflammatory effect, we use 0.5-3% concentrations. substance P and the burning sensation, as well as local pain is
relieved. We use a Caspicum annuum tincture as our capsaicin
source and use it in a hydrophilic cream base at 10%--that is 3 ml
of tincture (5:1) in 30 gms of base

FOOT FETISH

Two categories: clean or dirty feet

Let your imagination run wild…

Feet are the most common body

part fetish and shoes are the most
common accoutrement fetish…

FOOT ODOR-BROMODOSIS FOOT FUNGUS/ATHLETE’S FOOT

Bromodosis is due to a buildup of sweat in enclosed Tinea pedis, commonly known as athlete's foot, results from fungal infections on the skin of the feet caused
footwear, which results in bacteria growth on the skin by dermatophytes, including Trichophyton rubrum,T mentagrophytes,T interdigitale, and Epidermophyton floccosum.
that produce odors. These bacteria are naturally present
on our skin as part of the human microbiome. The front This infection typically occurs through direct contact with the organism while walking barefoot in locker
part of the foot produces the most sweat. rooms, showers, and swimming complexes. Individuals with diabetes and those who wear occlusive shoes are
at an increased risk.
Given that socks directly contact the feet, their
composition can affect foot odor. Synthetic materials like
polyester and nylon afford less ventilation to the foot
than do cotton or wool, leading to increased perspiration
and odor, although they can also reduce incidence of
blisters by wicking away perspiration. Many synthetic
socks are treated with chemicals to help reduce odor.
Wearing closed-toe shoes without socks leads to
accumulation of sweat, dead skin cells, dirt, and oils,
further contributing to bacterial growth and odors of
renown.

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TOPICAL ANTI-FUNGAL APPROACHES-

Topical imidazoles such as clotrimazole, econazole, ketoconazole, miconazole,

isoconazole, tioconazole, and sulconazole offer effective remedies with a very
low incidence of adverse effects. They interfere with the Cytochrome P450
system of both humans and the fungus, some people experience an increase
in their liver enzymes as a result, even topical application can do this.

Topical application of terbinafine and amorolfine yields faster results in

treating tinea pedis than clotrimazole treatment, adding a topical keratolytic,
like a 3-5% salicylic acid, can be beneficial in patients with hyperkeratosis.
Using prophylactic tolnaftate powder after swimming and showering in
community settings reduces the levels of toe cleft tinea pedis caused by T
interdigitale. Generally, topical treatment lasts for 4 weeks, although some
patients may experience symptom resolution sooner. Terbinafine 1% can
provide effective results for interdigital tinea pedis after 1 week. Repeated
KOH scrapings and cultures should yield negative results.

ENCELIA FARINOSA-BRITTLE BRUSH

BAKING SODA-SODIUM BICARBONATE
Baking soda is notably anti-fungal, and it
controls odors. Adding it to one’s shoes is a A member of the Asteraceae family, a perennial shrub with a native
distribution that grows throughout the Sonoran desert from northern
rapid way to resolve both foot fungus and
Mexico to Arizona including the Mojave Desert and the coastal chaparral of
foot odor. The baking soda tends to have a
southern California, the interior valleys of southern California, and
drawing effet, increasing the amount of southwestern Utah. This shrub is very drought tolerant and important for
sweat from the feet, it is imperative to keep revegetation and erosion control and habitat restoration.
the feet as dry as possible—a second or It reproduces asexually by being easily broken and portions of branches get
third pair of shoes to change into with fresh deposited elsewhere and root. The broken ends secrete a yellow resin that
socks through the day. Baking soda is not dries and can be easily collected. A standard beeswax and olive oil salve with
kind to all of the materials that shoes are 10% Encelia resin added to it is amazingly antifungal and smells wonderful—
made from and can seep through the fabric you too could garner the nickname honeyfoot.
as a white crust, no one loves that but it may Depending on the presentation of the fungal infection, a beeswax and olive
be a small price to pay. oil preparation may not suit your needs, it tends to be heating.

MONOLAURIN PERIPHERAL NEUROPATHY

Monolaurin, glycerol monolaurate (GML)—is the monoester
formed from glycerol and lauric acid. Lauric acid is a naturally
An umbrella term for nerve conditions that affect a
occurring 12-carbon medium-chain saturated fatty acid. The specific subdivision of the nervous system. Many
significant dietary sources of GML are coconut oil, human breast different conditions can cause peripheral
milk and palm kernel oil. GML is a surfactant and has been used neuropathy, which means a wide range of Neuropathy is a common complication of
for decades as a dispersant and emulsifier in the cosmetics symptoms is also possible. Peripheral neuropathy diabetes, peripheral artery disease (PAD),
industry and as a preservative food additive in the food industry. can also affect different body parts, depending on alcoholism, autoimmune disorders and
The antimicrobial activity of fatty acids and their esters is well how and why it happens—diabetic neuropathy and exposure to toxins/medications. Loss of
known, with chain length, unsaturation (cis, trans), and functional chemotherapy induced neuropathy are the most protective sensation means that
groups all being variables that affect this activity. GML is 1 of the common causes and occurs in hands and feet. individuals may not feel pain or
more potent of these antimicrobial agents, being up to 200 About 2.4% of people globally have a form of discomfort from minor injuries or
times more effectual than lauric acid in bactericidal activity
peripheral neuropathy. Among people 45 and older, pressure points, increasing the risk of
against certain microbes in in vitro studies. Dosage begins at 1-5
that percentage rises to between 5% and 7%. unnoticed wounds and subsequent
grams and it is helpful to reduce the systemic fungal load.
complications.

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A nerve is made up of bundles of neuronal

dendrites and/or axons SULBUTIAMINE/ BENFOTIAMINE/
The fibers are protected by myelin and outside the
FURSULTIAMINE
Schwann cell membrane the axon is covered by a
fascial stocking, the endoneurium bundled into
Fat-soluble forms of Thiamine (B1)-derived from garlic-
fascicles inside perineurium.
derived allithiamine.
Several fascicles are then bundled inside the Lipophilicity allows for better neurological uptake and
epineurium with more fascia, fat, and blood utilization
vessels. In a transected nerve, these fascicles are Sulbutiamine and Fursultiamine have CNS anti-
seen pouting from the cut surface, their
inflammatory effect and reduce mental fatigue
perineurial sheaths well-defined and strong
enough to be grasped by fine instruments. The Benfotiamine has anti-inflammatory effect in
groups of fascicles that make up a nerve trunk are peripheral nervous system
enclosed in an even thicker fascial coat, the neuropathy
epineurium. The epineurium varies in thickness neuralgias
and is particularly strong where the nerve is
Dosage is 50-200 mg 1-2 times/day--
subjected to movement and traction, for example
near a joint.

PALMITOYLETHANOLAMIDE-PEA PEA inhibits peripheral inflammation and mast cell

degranulation, as well as exerts neuroprotective and
antinociceptive effects; these actions are accompanied by
Naturally occurring fatty acid amide which was first isolated and described a decrease in NO production, neutrophil influx, and the
in 1957 as N-(2-hydroxyethyl)-palmitamide. Initially extracted from
expression of proinflammatory proteins, such as iNOS.
soybean lecithin, egg yolk, and peanut meal it was reported to have anti-
inflammatory properties and found to be an endogenous compound in the PEA protects endothelial function from oxidative and
human body. inflammatory injuries and improves neurological,
PEA is a member of the “endocannabinoid system” and possesses a emotional, and biochemical outcomes following TBI
bio-similarity and synergy with the CB1and CB2 agonist, anandamide. It through amelioration of the secondary injury components
belongs to the so-called “paracannabinoid messengers” and provides a
of TBI.
consistent analgesic effect through peripheral and central nociceptive
mechanisms and modulates several protective responses in inflammatory We find that dosages of 300-600 mg/day can be very
and pain conditions through modulation of both mast cell and glial cell helpful in mitigating flares, improving energy levels and
activity in neuro-inflammatory conditions. reducing neurological inflammation. Most commonly we
The first clinical applications of oral PEA formulations were published in employ a strategy of 600 mg/day for 3-4 weeks, then 300
the mid 1970’s evaluating the use of PEA as a respiratory infection
mg/day for 3-4 weeks and then take a month or two off.
prophylactic and reported a significant reduction in systemic pain,
reduction of fever, and lowered incidence of URI’s.

AMANITA MUSCARIA- TOPICAL APPLICATION

FLY AGARIC
Possibly the worlds oldest hallucinogen, linguistic evidence suggests use as far back Often a tincture can be applied topically on the order of 2-3 drops to an
area in pain, or, more commonly, added to a lotion or pain cream. A tincture
as 4000 BCE…Arguably the ‘Soma’ of the Hindu Vedas
preparation like the following mixed into a lotion or salve base can be very
Used worldwide as a spiritual sacrament-from the Kamchatka peninsula of Russia to
effective for nerve pain:
the Ojibwa people of the Great Lakes region of North America and into Meso-
America 1 oz Amanita muscaria 1:3 tincture or acetract
1 oz. Lobelia acetract
The major isoxazoles are ibotenic acid and muscimol 1 oz Atropa belladonna acetract
Decarboxylation of neurotoxic ibotenic acid during drying or digestion can result in 1 oz DMSO
the formation of less toxic, more psychotropic muscimol.
Share a structural similarity with glutamic acid and GABA.
Ibotenic acid is an agonist of NMDA receptors-causes an agitated delirium The Amanita is specific for swollen, inflamed nerves, like a sciatic nerve that
Muscimol is a potent GABAA agonist that affects brain serotonin, noradrenalin, causes a spasticity of the low back.
and dopamine levels in a manner similar to LSD, psilocybin, and mescaline. The Lobelia and Belladonna are both nice topical antispasmodics. I have
seen this preparation work very rapidly to bring relief that wasn't
Dosage: 10-15 mg Muscimol—Depending on source—1-3 mushroom caps forthcoming by other means.

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ACUTE BONE INJURIES, BROKEN BONES AND CONTUSIONS

SPECIFIC NEUROPATHY TREATMENTS
Topical transdermal gel: 10% Ketamine, 6% Gabapentin, 3% Pentoxifylline—8% These are injuries that are generally going to take at
diclofenac and 2% amitryptiline also worth considering least 6 weeks for recovery. Not weight bearing is
R-Alpha Lipoic Acid—600 mg/day is often very helpful the hardest part for most people.

Methyl donors—Levomefolic Acid (5-MTHF) 5 mg/day, Pyridoxal 5 phosphate 200 Pain relief can be achieved with anodyne and
mg/day, Methylcobalamin 2 mg/day analgesic botanicals, stabilization of fractures is
Sulbutiamine/Benfotiamine/Fursultiamine-Fat soluble Thiamine derivatives--50- critical.
400 mg/day
Agmatine—Derived from the decarboxylation of Arginine, peripheral vasodilator Anabolic botanicals like Cissus, Panax, Symphytum,
1-1.5 gms/day. Anantamul combine well with an anabolic dietary
strategy.
Alternating hot/cold foot baths 4 min. hot/1 minute cold—9-10 alternations before
bed. Minerals like calcium (hydroxyapatite), magnesium
Wet Socks—damp cotton socks placed on feet before bed with wool socks over (threonate, malate, taurinate), zinc
(monomethionine aspartate), silicea can be helpful
in encouraging the healing response.

CISSUS QUADRANGULARIS WITHANIA SOMNIFERA-ASHWAGANDHA

Ashwagandha is a Sanskrit name meaning “the smell and strength of a horse”
Cissus quadrangularis is an ancient medicinal plant that was It has a mild sedative action, which is why the species name somnifera.
prescribed in the ancient Ayurvedic texts as a general tonic and
The constituents of this plant include the steroidal compounds withaferin A
analgesic with specific bone fracture healing properties. (a steroidal compound with a molecular structure incredibly similar to cortisol)
Modern research has shown it to have a glucocorticoid and several sitoindosides.
antagonistic effect, it has anabolic effects in its ability to offset This plant is a member of the Solanaceae family and so, also contains several
cortisol effects, it helps preserve muscle mass as well as bone tropane alkaloids like tropine and pseudotropine.
mass. One of the theories that might explain why this plant can have dramatic effects
on testosterone levels in men and women is that some of its steroidal constituents
It has a relaxing effect and promotes deeper more restful sleep. will bind to cortisol receptors, inhibiting binding of cortisol. These compounds
will exert an effect on the cortisol receptor that is much less than a cortisol
A wonderful recovery agent on its own or married to induced effect and is relatively sedating.
Hemidesmus, Withania, or Panax.
In essence, Ashwagandha may have the ability to effectively block catabolic
Dosage is 100-500 mg 3 times a day activity via blocking cortisol. I dose this herb at 2-5 grams before bed for most
people

HEMIDESMUS INDICUS BUNION

Indian Sarsaparilla is regarded as a bitter, blood purifier, astringent, depurative, A bunion refers to a bony bump at the base of the big toe. The
carminative, tonic, anti-syphilitic, anti-leucorrheic, antiviral, antifungal, antibacterial,
most common form of bunion, “hallux valgus,” is formed by
anti-inflammatory, anti-diarrheal, anti-rheumatic, febrifuge and alterative.
a change in the alignment of the bones., it is a failure of the
This herb is useful in autoimmune/rheumatic conditions, chronic skin disorders (esp metarsal arch and the collapse has pushed the big toe
psoriasis), leukoderma, gonorrhea, asthma, bronchitis, hemorrhoids, jaundice and medially.
dysentery.
This is related to bad footwear and some predisposing
Clinically effective at helping people maintain an anabolic state. genetics. Cowboy boots and high heeled shoes with pointy
Dosage is 1-4 grams/day toes are direct contributors to this phenomenon. It represents
a type of modern footbinding. Serial casting can help prevent
It is a pleasant smelling powder
further migration of the bone, but once the arch has
collapsed, it has to be rebuilt.
Consider minimalist footwear with a wide toe box and flat
heel, ease into them by wearing them for short durations until
your foot conforms to them.

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Footwear is the
primary cause of PLANTAR FASCIITIS
most of the significant
A prevalent and painful condition arising from the
foot issues for which degenerative irritation of the plantar fascia origin
people seek out at the medial calcaneal tuberosity of the heel and
medical care— its surrounding perifascial structures. The plantar
fascia comprises 3 segments originating from the
including bunions, calcaneus and plays a pivotal role in maintaining
corns, hammer toes, the normal biomechanics of the foot, providing
essential arch support, and serving as a shock
neuromas, fungal absorber.. In the United States, millions of
infections, and plantar individuals suffer from heel pain each year, with
plantar fasciitis being a primary culprit. While
fasciitis. multifactorial in its origins, overuse stress is often
the leading cause, presenting with sharp localized
pain at the heel and, occasionally, a heel spur.

ATROPA BELLADONNA-
DEADLY NIGHTSHADE BELLADONNA PREPARATIONS
Atropa belladonna, is named for Atropos, one of the three fates in Ancient Greek Assuming 1.2-1.3% alkaloidal content in leaves and roots, with a preponderance of the
mythology. This particular fate was responsible for cutting the thread of life. Her alkaloids in the form of L-Hyoscyamine (87.6% in Leaves and 68.7% in roots), which
converts into a less active, more stable racemic mixture of D,L-Hysocyamine. A standard
second name has associations with the Italian goddess of battle Bellona. dilution for a tincture is 1:5 dilution of herb in solvent, which produces a product that is
Consumption creates a light sensitivity and blurred vision (due to dilation of the 2.4-2.5 mg of alkaloid per ml of tincture. The solvent is usually a higher alcohol percentage,
pupils), a sense of floating and spatial expansion beyond the body, drying of bodily usually 65%, and the addition of an acidic element like apple cider vinegar might help keep
fluids and inability to urinate, altered heart rate, sweaty hands, and a sense of the alkaloids in a free base form.
being surrounded by the dead. Assuming 30 drops per ml, each drop is 83 mcg of tropane alkaloids, 5 drops provides 415
mcg or 0.415 mg…
Contains the tropane alkaloids atropine, scopolamine, and hyoscyamine, which are
made in the roots of the plant and collect in the leaves and stems after harvesting Most atropine eyedrops are 1% so they are 10 mg/ml, and one uses 1-2 drops at a time,
the plant. which is 0.33 mg/drop.
All parts of the plant contain tropane alkaloids. Roots have up to 1.3%, leaves Atropine injections come as 0.05 mg/ml up to a 1mg/ml and for maintenance of
1.2%, stems 0.65%, flowers 0.6%, ripe berries 0.7%, and seeds 0.4% tropane secretions and an anti-vagal effect, dosage begins at 0.5-1 mg every two hours, for
alkaloids; leaves reach maximal alkaloid content when the plant is budding and organophosphate poisoning dosage is 2-3 mg every 30 minutes, and in bradyasystolic
flowering, roots are most potent at the end of the plant's vegetation period. cardiac arrest, dosage is 1 mg every 3-5 minutes with a maximum of 3 mg.
Belladonna nectar is transformed by bees into honey that also contains tropane 5 drops of tincture is often our dose, and we might do that 3-4 times a day in cases of
alkaloids. The berries pose the greatest danger to children because they look gastrointestinal cramping, or to relax stiff muscles. It seems to have some affinity for the
attractive and have a somewhat sweet taste, each berry can contain 2 mg of GI tract and skeletal muscle.
atropine. The root of the plant is generally the most toxic part, though this can
vary from one specimen to another

DATURA
METELOIDES/WRIGHTII/INOXIA
A member of the Solanacae family, Datura is distinctive by large white
“trumpet” flowers that uncoil in a five-pointed pinwheeling fashion.
Datura as a genus can be found across multiple continents, including
the Americas, Asia, Europe, and South Africa. Its wide availability and
physiologic properties, largely due to the presence of the tropane
alkaloids.
A noted usage of Datura in Native California is in youth initiations
where the root was processed into a drink or “tea” known
historically as toloache. Initiates would often be instructed in cultural
rules of entering adulthood and how to interpret the visions
themselves. For some, these ceremonies were highly codified and
included activities like vigils and the making of sand paintings that
emphasized religious principles.
May 17, 2025 84

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Tropane Alkaloids: Datura

• Jimsonweed, Locoweed, Sacred Datura,
Datura Dosages
‘ Potters asthma cure’ in Europe
• Datura seeds have been found in Archaic Given that our plant material is going to be leaves and aerial stems we are looking at material
that is 0.9-1.0 mg/gm atropine and 0.33 mg/gm scopolamine, and we are making a 1:5 dilution,
period (at least 4500 years ago) sites in the
our finished product provides 0.2 mg/ml atropine and 0.066 mg/ml scopolamine, among other
Lower Pecos of Texas, in Ancestral Pueblo alkaloids that serve to temper the effect.
(AD 1250–1300) contexts in present-day Scopolamine is more lipid soluble than atropine, so has greater effects in the central nervous
Colorado, and in Mississippian (AD 1100– system. Peripherally this results in smooth muscle relaxation and reduced gland secretion.
1200) contexts. Imagery and Datura fruit Centrally scopolamine is more sedating, but anxiety and restlessness can occur at higher doses.
effigy pottery vessels confirm its presence The vomiting center of the brain is located in the medulla oblongata and scopolamine exerts an
from Mexico into the Southwest and anti-emetic action by primarily affecting the M1 receptor.
Southeast regions of the US. The sixteenth-
century Aztec-language Florentine Codex The scopolamine patch is pure alkaloid in a sustained release form that delivers a 140 mcg
loading dose when the patch is applied and then the medication is absorbed on the order of 0.5
includes Datura as an important medicinal
mg/24 hrs for 3 days.
plant among the Aztecs.
• Antispasmodic 500-year-old Our product is not pure alkaloid, but it is safe to say that the equivalent scopolamine loading
Chumash Datura dose from the tincture could be 2 mls, (132 mcg scopolamine), but the herbal product is
• Narcotic anodyne flower depiction effective at a lower dose range and we find that 5-15 drops is a decent dose for nausea and
• Psychotropic at Pinwheel cave, PRESENTATION TITLE
vomiting related to motion sickness or vestibular dysfunction. Acute asthma attacks2 0 will
XX
often 86
California respond to five drops administered orally.

PLANTAR FASCIITIS CREAM

In 400 ml of cream base, still melty A dynamic orthotic is generally

and hot, add a ¾ foot orthotic that
50 ml of Datura acetract compresses with body with
50 ml Atropa acetract body weight and then recoils
75 ml Lobelia acetract upward with each step, causing
DMSO 25 ml activation of the muscles of the
sole and the arches of the foot.
This can be applied to the affected Powerstep, Spenco and other
foot 3 times a day and generally companies make them, it is wise
provides a tremendous amount of to get professionally fitted.
relief

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The Foot--The Natural History of an Appendage

Dr. Kenneth Proefrock

The human foot contains 26 bones, 33 joints, and over 100 muscles, tendons,
and ligaments, all wrapped together in layers of fascia and working with a
coordinated effort to support and move the body, while allowing for a range of
movements that include the delicate balance required for tiptoeing to the powerful
thrust needed for sprinting. The arches of the foot represent an architectural
marvel, absorbing and distributing the impact of each step, reducing stress on the
rest of the body and maintaining overall stability and balance. Feet are also at the
bottom of us, closest to the ground and subject to a certain amount of abuse and
neglect. The daily activities of walking, jumping, and running, can lead to
inflammation, bruising, and strain/sprain injuries, and the primary causes for foot
pain today are improper footwear, diabetes and inactivity.
In order to discuss the various conditions that can affect the foot and ankle, it
may be important to understand the normal anatomy of the foot and ankle.
The ankle itself consists of three bones attached by muscles, tendons, and
ligaments that connect the foot to the leg. The major bones of the lower leg are the
tibia and the fibula. These bones articulate with the talus or ankle bone at the
tibiotalar joint (literally where the tibia meets the talus-ankle joint) allowing the
foot to move up and down.
The foot can be divided into three anatomical sections called the hind foot,
mid foot, and forefoot. The hind foot consists of the talus bone, the highest bone in
the foot, and the calcaneus, the heel bone, which is also the largest bone in the foot.
The hind foot connects the mid foot to the ankle at the transverse tarsal joint. The
mid foot contains five tarsal bones: the navicular bone, the cuboid bone, and 3
cuneiform bones. It connects the forefoot to the hind foot with muscles and
ligaments, primarily the plantar fascia ligament. The mid foot is responsible for
forming the arches of your feet and acts as a shock absorber when walking or
running. The forefoot consists of the long bones in the feet, the metatarsal bones,
and the toe bones, the phalanges, which connect with one another at the ball of the
foot by joints called phalangeal metatarsal joints. Each toe has 3 phalange bones
and 2 joints, while the big toe contains two phalange bones, two joints, and two
tiny, round sesamoid bones that enable the toe to move up and down. Sesamoid
bones are bones that develop inside of a tendon over a bony prominence. The first
metatarsal bone connected to the big toe is the shortest and thickest of the
metatarsals and is the location for the attachment of several tendonsand is
important for its role in propulsion and weight bearing.
The foot and ankle bones are held in place and supported by various soft
tissues.

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• Cartilage: Shiny and smooth, cartilage allows smooth movement where two
bones come in contact with each other.
• Tendons: Tendons are soft tissue that connects muscles to bones to provide
support. The Achilles tendon, also called the heel cord, is the largest and
strongest tendon in the body. Located on the back of the lower leg it wraps
around the calcaneus.
• Ligaments: Ligaments are fascial structures that are strong rope-like tissues
that connect bones to other bones, stabilize tendon positions and provide
stability to the joints. The plantar fascia is the longest ligamentous structure
in the foot, originating at the calcaneus and continuing along the bottom
surface of the foot to the forefoot. It is responsible for the arches of the foot
and provides shock absorption. Plantar fasciitis happens when repetitive
micro tears occur in the plantar fascia from overuse. Ankle sprains, the most
commonly reported injury to the foot and ankle area, involve ligament strain,
and usually occur to the talo-fibular ligament and the calcaneo-fibular
ligament.
• Muscles: Muscles are fibrous tissue capable of contracting to cause body
movement. There are 20 muscles in the foot and these are classified as
intrinsic or extrinsic. The intrinsic muscles are those located in the foot and
are responsible for toe movement. The extrinsic muscles are located outside
the foot in the lower leg. The gastrocnemius or calf muscle is the largest of
these and assists with movement of the foot. Muscle strains occur usually
from overuse of the muscle in which the muscle is stretched without being
properly warmed up.
• Bursae: Bursae are small fluid filled sacs that decrease friction between
tendons and bone or skin. Bursae contain special cells called synovial cells
that secrete a lubricating fluid.
• Fascia: Fascia is, literally, the biological fabric that holds our body together,
a three-dimensional spider web of fibrous, gluey, and wet proteins that acts
like a bracing and organizing scaffold for the physical form. Understanding
fascia is essential to understanding the dance between static and dynamic
bodily processes, between the experience of pain and that of comfort, it is
crucial to physical performance, central to recovery from injury and
disability, and an ever-present participant in our daily quality of life. Here,
and for our purposes, ‘fascia’ has to be given a broader biological definition,
it is, effectively, all of the collagenous-based soft-tissues in the body,
including the cells that create and maintain that network of extra-cellular
matrix (ECM). Fascia is one single, vastly interconnected, biomechanical
regulatory system with millions of tiny nerves moving in and out of adjacent
sheets of fascial material, into and out of contained compartments of fluid

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within muscles, organs and skin. Not only does it represent a structurally
critical component of the physical form, it also acts to transmit information
and resources throughout the system, often faster and more deliberately than
other bodily communication systems. Fascia is a resonant, vibratory
structure...if you have ever gone to a concert and stood too close to the
speakers and you feel that vibration go through your entire being, those
vibrations are being carried through the fascial system.
Biomechanics is a term to describe movement of the body. The ankle joint by itself
permits two movements:
• Plantar flexion: Pointing the foot downward. This movement is normally
accompanied by inversion of the foot.
• Dorsiflexion: Raising the foot upward. This movement is normally
accompanied by eversion of the foot.
The foot (excluding the toes) also permits two movements:
• Inversion: Turning the sole of the foot inward.
• Eversion: Turning the sole of the foot outward
The toes allow four different movements:
• Plantar flexion: Bending the toes towards the sole of the foot
• Dorsiflexion: Bending the toes towards the top of the foot
• Abduction: Spreading the toes apart. This movement normally accompanies
plantar dorsiflexion.
• Adduction: Bringing the toes together. This movement normally
accompanies plantar flexion.
Feet have been a source of certain fascination for humans the world over
from time immemorial. The earliest known hominids, such as Ardipithecus
ramidus and Australopithecus afarensis, had feet that were adapted for climbing
trees, with flexible toes and a grasping big toe that could grip branches. As early
hominids began to walk upright on two legs, their feet gradually evolved to support
this new mode of locomotion. The arches of the foot developed to absorb shock
and provide stability, while the toes became shorter and less flexible. Around 2
million years ago, the time of Homo erectus, the foot had become more like a
modern foot in appearance, with a longitudinal arch and a non-grasping big toe that
was aligned with the other toes. This allowed for more efficient walking and
running. The evolution of the foot continued with the appearance of Homo sapiens
around 300,000 years ago. The arches of the foot became more pronounced,
providing greater shock absorption and helping to distribute weight more evenly
across the foot1. In the last few thousand years, the human foot has undergone
further changes due to cultural factors such as footwear. Shoes have altered the
shape of the foot, leading to a higher incidence of foot problems such as bunions,
hammertoes, and flat feet2.

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Cultural factors have influenced the human relationship with their feet in a
myriad of ways, from interesting sexual fetishes, to seemingly barbaric footbinding
rituals, bracing and serial casting to create more attractive or more functional feet,
to a renewed conversation about whether or not shoes are good for us or not so
good for us. For sure, it is a complicated story and what we think we know about it
may not be the truth of the matter3,4. Some of the pertinent cultural factors have
been embedded in that most revered of historical fictions, the fairy tale, in fact,
potentially the very first story to be considered a fairy tale, Cinderella5. The earliest
recorded story featuring a Cinderella-like figure dates to the 6th century BCE in
Greece and features a woman named Rhodopis whose shoe is stolen by an eagle,
who flies it all the way across the Mediterranean and drops it in the lap of an
Egyptian king. A shoe dropping from the heavens felt enough like a supernatural
sign that the king went on a quest to find the owner of the shoe, he eventually finds
Rhodopis and marries her, lifting her from a lower social status to the highest
social status. Another one of the earliest known Cinderella stories is the ninth-
century Chinese fairy tale, "Ye Xian", first published in the Tang dynasty
compilation Miscellaneous Morsels from Youyang written around 850 by Duan
Chengshi6. This story profiles a young girl named Ye Xian who is granted a wish
by some magical bones, which she uses to create a gown and matching shoes in the
hopes of finding a husband, eventually a monarch comes into possession of one of
the shoes and goes on a quest to find the woman whose tiny feet will fit the shoe,
he finds her and Ye Xian’s beauty convinces the king to marry her--again, lifting a
female from a lower social station to a higher one, at a time when marriage may
have been the primary means of social mobility for women.
In total, more than 500 versions of the Cinderella story have been found
throughout the world and the one that we might know best comes from a 17th
century story with title character, Cendrillon, by Charles Perrault, the French writer
credited with inventing Mother Goose and the fairy tale7. He cast the form that
Cinderella would take for the next 400 years, introducing the glass slipper, the
pumpkin, the wicked stepmother and stepsisters, and the fairy godmother, the
version that Disney animated and injected into modern pop culture in the 1950's.
Many fairy tales that have their roots in the 17th century, including Snow White
and Hansel and Gretel, feature similar themes and especially evil stepmothers who
seek to ruin the protagonist’s lives. In all of these stories, the stepmother’s primary
enemy is her step-children, living, breathing reminders of her husband’s first
marriage, a situation made more complicated by stepchildren who adopt an anger
and resentment on behalf of their birth mother (usually deceased) and become her
proxy in their father’s household. These represent cultural stereotypes, roles that
are pre-written and too easy to adopt, and this is a problem just as relevant today as
it was 500 years ago. Step-parents, historically, were a very common occurrence

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not because of divorce and remarriage but because so many women died during
childbirth. This meant the new wife (and her children) were in direct competition
with the first wife’s child not just for love and attention, but also for the inheritance
that would decide which station of society they would belong to after the husband’s
death.
We know the gist of the story, Cinderella has unique feet, in some versions,
she has perfect feet, and why a glass slipper? so you can see her perfect feet, like a
type of voyeurism, seeing some seldom seen but perfect part of someone else's
anatomy. It involves the innocent and abused Cinderella with her delicate features,
and perfect feet, her narcisstic stepmother and stepsisters, and a handsome prince
who is smitten by the owner of the special shoe. In the Grimm Brother's 1857
version, the stepsisters feet are much too large for the slipper, so their mother
reassures them that once they become queen, they won’t have to walk, one sister
cuts off her heel while the other amputates a toe8. In Perrault's tale, their deception
is revealed to the prince by two pigeons perching in a hazel tree with the following
lines:
Looky, look, look
At that shoe that she took,
There’s blood all over, her foot’s too small,
She’s not the bride that you met at the ball9.
When the Prince slips the shoe onto Cinderella’s foot, she is found to be a perfect
fit in size and form. Her small foot becomes proof of her ‘natural’ superiority, with
an inferred morality, intelligence and grace. Recall that in the 1950 animated
version from Disney, the stepmother and stepsisters have oversized feet, bulbous
noses, and hairy bodies, indicating their bestial, baser natures while Cinderella is
small, delicate-featured and smooth-skinned. On the one hand, the story is about
the right of innocent, honest, hardworking girls to ascend in the class structure, but
also tied to a matrimonial attachment. On the other hand, and we can act like they
aren't, but feet are also about sex, the prince may be the first recorded foot fetishist.
Leading us to that strange domain of Freud, who identified feet as the primary
sexual fetish, in fact, foot fetishes account for nearly half of all fetishes associated
with body parts today; and footwear is the most popular non-bodily oriented fetish,
capturing one-third of all fetishists.
Foot fetishism may have reached a cultural apex in Brazil in the mid-1980s
with a movement called Feetishism, started by Glauco Mattoso, a blind
Brazilian poet. He created this transgressive, consciously indecent theology that
sought an unveiling of God’s love though the power of massagem linguopedal or
‘tongue-foot massage’. Adherents were encouraged to lick and kiss

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the sweaty, filthy feet of the oppressed and the oppressors in an active
demonstration of love and respect. Workers and the destitute, homophobes and
policemen, were recipients of this sacramental act, which sought to
invert positions of power through the giving and receiving of pleasure. Mattoso
published The Feetishist Handbook: Adventures and Readings from a Guy Crazy
for Feet and, when that book became a cult classic with hundreds of followers, he
turned it into a cartoon called The Adventures of Glaucomix, The Feetishist10.
Followers of Glaucomix kissed and licked feet in a religious rite of self-
mortification and big-hearted human-sympathy for the unknowable ‘Other’. This
ideology of humility sought to give people permission to confront harmful
hierarchies and injustices. It was clearly a fetishistic theology, not in the sense that
Freud espoused (with his emphasis on castration and the female phallus) but in the
sense of the fetish as a displacement of the object of desire: the object of desire
being God, displaced to the feet of the poor, the sinning, and the sick. Feetishism
was a unique movement that drew on ideas, symbols and practices that have been
inherited from the ancient world. Notably, in India and in the middle east, the
custom arose where hosts would wash the feet of visitors (pedilavium), in a ritual
designed to transform Strangers into welcomed Guests. Krishna bathed the feet of
the Brāhmanas in an act of service and humility. The patriarch of Islam, Judaism
and Christianity, Abraham, offered to wash the feet of the angels invited to his tent
while on their way to destroy Sodom and Gomorrah. Both Muslims and Jews
ritually cleanse their feet before praying. In the New Testament, there are several
references like that of the female sinner who washed Jesus’ feet with her tears,
kissed them, dried them with her hair, and then anointed them with ointment.
During the Last Supper, Christ knelt before his disciples, and washed and kissed
their feet: ‘Do you understand what I have done for you?’ he asked them…. Now
that I, your Lord and Teacher, have washed your feet, you also should wash one
another’s feet. I have set you an example that you should do as I have done for you.
Very truly I tell you, no servant is greater than his master, nor is a messenger
greater than the one who sent him. Now that you know these things, you will be
blessed if you do them’.
Washing someone's feet is a deeply humbling act of hospitality and service, it
changes you and it changes them...and at least one of you has clean feet at the end.
It speaks to a certain transformative power inherent in our lowest appendage.
Feet and their coverings have meaning, they connect us to the earth, they
represent the paths we have tread and the work we have done, we talk about
"walking a mile in my shoes" as a way for someone to understand us. Podoscopy
was proposed as a 'science of the feet', propelled by the popularity of physiognomy,
many practitioners claimed they could diagnose character by the shape and form of
the foot. The practice was promoted by writers in the early 1800's with names like

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‘Philopedes’ (literally 'foot lover'), who published in 1825 that ‘if you may know a
man from the bumps on his skull, the wrinkles on his face, or the characters of his
hand-writing, so you may know him from the shape and outline of his feet. The
shallowest of observers may clearly discern, in the capacious, full-grown, and
well-formed foot, the plainest indications of a vigorous and masculine
understanding. What eloquence in the bold sinew, in the strong tendon! What
firmness exhibited by the sound hearty brown! No flabbiness, no superfluous flesh,
nothing to impede the free use of the member! Can such a FOOT be given to a
sluggard?"11 Old ideas about perfection of the body equating to a perfection of
character, and the other side of the coin, your personal imperfections evidenced by
imperfections in your physical form. One author in Hearth and Home on 10
May,1894, wrote that it was a ‘fallacy’ that, in women, ‘small extremities signify
high breeding’. He contended that small feet were not hereditary but were ‘the gift
of Nature, like a Cupid’s bow mouth, golden hair, and dimples, but their possessor
is usually as proud thereof as though she were their creator', he goes on to promote
the view that the ‘luckless… big-soled girl’ should be deeply embarrassed by her
appendages. He noted that such girls and women were acutely conscious of a
‘short-coming in this matter of beauty’ and so is likely to be ‘anxious to please, and
to win affection by other means than charms of person’, because although ‘the
average man is never insensible to the charms of a tiny foot, he is not repelled by
the sight of a large one if it be smartly and appropriately shod’11. In stark contrast,
men in rural areas like North Sumatra (Indonesia), share an overwhelming
preference for women with large feet. And at least one major study revealed that
the preference for large female feet was positively correlated with rural societies all
over the world who have had the least exposure to the Western media12.
There are few places on earth, and in history, that have taken foot
modification to the extremes that China has with their obsession surrounding the
‘three-inch golden lotus’ feet of women and the controversial practice of foot-
binding. A practice that is said to have been inspired by a tenth-century court
dancer named Yao Niang who bound her feet into the shape of a new moon and
enamored the Emperor Li Yu by dancing on her toes inside a six-foot golden lotus.
Foot-binding became very culturally entrenched and was once widespread
throughout China, with significant major regional variations, for nearly one
thousand years. In addition to altering the shape of the foot, the practice also
produced a particular sort of gait that relied on the thigh and buttock muscles for
support. From the start, foot-binding was imbued with erotic overtones. Gradually,
other court ladies—with money, time and a void to fill—took up foot-binding,
making it a status symbol among the elite. By the eighteenth century, Fang Xun
(known as the ‘Doctor of the Fragrant Lotus’) recorded 58 different types of bound
feet, which he put into five categories: lotus petal, new moon, harmonious bow,

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bamboo shoot, and water chestnut5. A small foot in China represented the height of
female refinement and for families with marriageable daughters, foot size
translated into its own form of currency and a means of achieving upward mobility.
The most desirable bride possessed a three-inch foot, known as a “golden lotus.” It
was respectable to have four-inch feet—a silver lotus—but feet five inches or
longer were referred to as iron lotuses, and did not translate well to marriage
prospects. Feet-binding is a laborious and painful procedure, often starting when a
girl was around six years of age and, by adulthood it was irreversible13. It is often
(although not always) imposed upon young girls against their inclinations because
the process is agonizing as it involves radical remodeling of bones and tissue and
severely impedes a normal walking gait. The process begins with the feet soaked in
hot water and toenails clipped short, the feet were massaged and oiled before all
the toes, except the big toes, were broken and bound flat against the sole, making a
triangle shape. Next, the arch was strained as the foot was bent double and the feet
wrapped tightly using a silk strip measuring ten feet long and two inches wide.
These wrappings were briefly removed every two days to prevent blood and pus
from accumulating and to watch for infection in the foot, sometimes “excess” flesh
was cut away or encouraged to rot. The girls had to walk long distances in order to
speed up the breaking of their arches and remodeling of the feet, over time the
wrappings became tighter and the shoes smaller as the heel and sole were brought
closer together, the process was complete after two years. Once a foot had been
crushed and bound, the shape could not be reversed without a woman undergoing
the same pain all over again. In Cinderella’s Sisters, historian Dorothy Ko argues
that the western emphasis on ‘cultural practices’ such as foot binding recasts
Chinese women as victims. Ko advises us to emphasize female agency, observing
that ‘a pair of shapely bound feet was the lifelong handiwork of women’. Ko points
out that foot binding was ‘not merely an announcement of status and desirability to
the outside world, but also a concrete embodiment of self-respect to the woman
herself’ and could not have become so widespread, or lasted a thousand years,
without their participation5.
The feet of professional dancers, especially ballerina's feet are also the
product of agonizing labor, as such, suffering is an integral part of the art. As
described in Dance is a Contact Sport (1974)14, the use of pointe shoes and the
ways legs and feet must be positioned, forces dancers to…"defy the principles of
human design…. Human toes were not designed to stand on. Unfortunately,
dancers know this very well, but they stand on them anyway…. When dancers learn
to turn out 180 degrees from the hips, to dance on pointe, to hold their torsos high
off their waists, to arch and point their feet unnaturally, the muscles involved in
these operations are strengthened in one way but weakened in others". Other
authors compare the pointe shoe to the rack and thumbscrew, with ballerinas’ shoes

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often filling up with sweat and blood, having to be changed multiple times during
every performance. Fractures and sprains are common. Most of the damage is not
done by injuries but by ‘chronically overburdening the body’ through overwork,
fatigue, ignoring aches, and incorrect technique but many dancers are unwilling to
admit to injury for fear that it shows lack of dedication15. Edgar Degas was a
French Impressionist artist famous for his pastel drawings, oil paintings and
sculptures, he is especially identified with the subject of dance; more than half of
his works depict dancers, and especially their feet. When he died in 1917, he left
behind a legacy that captured the physical demands and often painful realities of
ballet, his portrayal of ballerina's feet was not about idealized beauty but rather
about the physical demands, the pain, and the realities of a life dedicated to dance.
Like the footbound women of China, the culture of pain that these broken feet
embody also excite fetishistic interest. The bunions, blisters, ingrown toenails, and
calluses that are routine for ballerinas are the equivalent of military feet in men. It
is no coincidence that the military call them ‘foot soldiers' and it is a part of
military lore that ‘an army lasts only as long as the feet of its infantryman’. Or,
more poetically, ‘Feet to the soldier are what tires are to the motor, wings to the
bird’ During the American Civil War, the Atlantic Monthly advised soldiers that the
most important attribute for a soldier was ‘good feet’.
The foot covering, the shoe, can be an objet d’art, a fetish, a sign of sexual
preferences or moral attitudes, and a performance of gender and identity. The shoes
that Vincent Van Gogh painted in 1886, simply titled ‘A Pair of Shoes’ has inspired
some of the great philosophical reflections of the twentieth century. Martin
Heidegger in his ‘The Origin of the Work of Art’ lectured about these shoes in
193516: "Out of the dark opening of the worn out insides of the shoe-tool stares the
toil of laborious steps. In the sturdy solid heaviness of the shoe-tool is stowed up
the stubbornness of the slow trudge through the far-stretched and monotonous
furrows of the field, over which a raw wind blows. On the leather lies the
dampness and fullness of the soil. Under the soles slides the loneliness of the
field path as evening falls. In the shoe-tool vibrates the silent call of the earth, its
quiet bestowal of ripening corn and its unexplained self-denial in the desolate
fallow of the winter field. Extending through this tool are the uncomplaining fear
as to the certainty of bread, the wordless joy of once again having withstood
need, the trembling before the arrival of birth, and the shaking at the
surrounding threat of death. To the earth belongs this tool, and in the world of the
peasant woman is it heeded. From out of this heeded belonging, the tool itself
stands up in its resting-within-itself." Heidegger provides an interpretation of Van
Gogh’s painting that reveals both the 'Being' of shoes and the truth of the peasant
women’s entire world to us, because those shoes are a manifestation of that world.

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Walking a mile in those shoes is to assume the social position of the original
wearer.
The most common medical conditions that affect the foot include athlete's
foot (Tinea pedis), bunions, diabetic neuropathy, ingrown toenails, Plantar fasciitis,
heel spurs and Morton's neuroma. In many cases, there may not be a pre-existing
effective intervention for the presenting condition and we have to create something
unique to impact a unique presentation. Athlete's foot is a cutaneous fungal
infection caused by a dermatophyte infection that is characterized by itching,
flaking, and fissuring of the skin. It is very much associated with the dampness of
the environment within the shoe and it may manifest in three ways: the skin
between the toes may appear macerated (white) and soggy; the soles of the feet
may become dry and scaly; and the skin all over the foot may become red, and
vesicular eruptions may appear. It effects 15-25% of the population at any given
time, and is a very contagious condition that is often contracted from public
showers and locker rooms and can spread to any area of the body, with groin and
armpits being very common. Conventional interventions includes anti-fungal
agents like allylamines and azoles, some of which are used topically and others
internally.
The allylamines were introduced in the 1980s as agents that exhibited a
broader spectrum of fungicidal activity against dermatophytes such as
Trichophyton rubrum, T mentagrophytes, T tonsurans, Candida spp and
Epidermophyton floccosum17. They work by inhibiting squalene epoxidase, an
essential enzyme in the ergosterol biosynthesis pathway of fungal cell membrane
formation. The two primary antimycotics in the allylamines family are terbinafine
and naftifine. Benzylamines are another class of antifungals that are structurally
similar to the allylamines. They operate via a similar mode of action, blocking the
epoxidation of squalene. Butenafine is the representative drug in this class.
Naftifine is a synthetic allylamine derivative that was incidentally discovered from
research into new agents for the treatment of central nervous system disorders.
Terbinafine was developed in 1979 by chemical modification of naftifine. They act
by inhibiting the enzyme squalene 2,3-epoxidase that converts squalene to
squalene oxide. Systemic absorption is approximately 6% of the applied dose after
a single topical application, they are highly lipophilic and exhibit good penetration
into the stratum corneum and hair follicles, they are both available in a 1%
concentration in gel and cream forms. Terbinafine is well absorbed from the
gastrointestinal tract after oral administration, with the peak plasma concentration
of 1 μg/mL detected within 2 hours after a single 250-mg dose and it can be
detected in the stratum corneum 24 hours after oral administration. It is also
detected in the hair and distal nails within 1 week of starting therapy at a dose of
250 mg/day. The most common side effects include burning, stinging, dryness,

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erythema, itching, local irritation, and, rarely, allergic reactions. Terbinafine

undergoes extensive metabolism in the liver. When compared with azoles,
terbinafine has affinity for less than 5% of CYP enzymes, giving it a relatively low
potential for affecting the metabolism of other drugs. Nevertheless, terbinafine is a
potent inhibitor of CYP2D6 and affects drugs that are predominantly metabolized
by this enzyme, such as tricyclic antidepressants, β-blockers, some selective
serotonin reuptake inhibitors, and monoamine oxidase inhibitors type B.
Terbinafine decreases the clearance of caffeine by 19% and increases the clearance
of cyclosporine by 15%.
Azole antifungals are divided into the imidazoles (miconazole and
ketoconazole) and the triazoles (itraconazole, fluconazole, voriconazole). The latter
group has three instead of two nitrogen atoms in the azole ring, all of the azoles
operate via a common mode of action: they prevent the synthesis of ergosterol, the
major sterol component of fungal plasma membranes, through inhibition of the
fungal cytochrome P450-dependent enzyme lanosterol 14-α-demethylase. The
resulting depletion of ergosterol and the concomitant accumulation of 14-α-
methylated precursors interferes with the bulk function of ergosterol in fungal
membranes and alters both the fluidity of the membrane and the activity of several
membrane-bound enzymes (chitin synthase)18. The net effect is an inhibition of
fungal growth and replication with a number of secondary effects, such as
inhibition of the morphogenetic transformation of yeasts to the mycelial form,
decreased fungal adherence, and direct toxic effects on membrane phospholipids,
also being reported. Unfortunately, as a result of the nonselective nature of the
therapeutic target, cross-inhibition of P450-dependent enzymes involved in human
liver function has been responsible for some toxicity, although significantly lower
and less severe with the triazoles than with the imidazoles. Note that the
mechanism here is not that different than the allylamine mechanism of action, for
patients with long-term fungal colonization, alternating these agents often provides
a better outcome and less liver toxicity. So many of our botanical medicines work a
lot better than these do, especially topically applied salves.
Salves are generally made from an oil base that is thickened with a wax, like
beeswax. One can start with an herbal oil infusion, warm it in a double boiler, and
slowly add small pieces of wax on the order of 1 part beeswax for every 8 parts oil.
More wax makes a thicker salve and less wax makes more of an ointment. An
excellent method for making quick salves is to add essential oils to the warm oil
and melted beeswax just prior to pouring into the salve containers. We usually use
1-2 tsp. (5-10 ml) of total essential oil per ounce of salve; an excellent antifungal
salve is ½ tsp each of oregano and thyme essential oils per ounce of final product.
If you don’t end up using essential oils in the salve, it is a good idea to make sure
that the oil base contains adequate Vitamin E oil (10% of total oil volume) to

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prolong the shelf life of your product. Other options for this kind of approach
include adding antifungal resins, we use pinon pine salve (Pinus edulis) and
brittlebush (Encelia farinosa) resin...essentially, while the oil portion is heating in
the double boiler you also add some resin--I find that a 5-10% resin content works
very well as an antifungal.
Brittlebush (Encelia farinosa) is a medium-size shrub with oval, silver-gray
leaves covered in tiny, fuzzy hairs. In the late winter and early spring, this Aster
family plant produces beautiful yellow flowers on stems extending above the
shrub. It is found throughout the Sonoran Desert and in the warmer areas of the
Mojave Desert. Its common name is derived from its fragile and breakable stems,
which is also how the plant spreads asexually. The O’odham and Seri natives used
the viscous and transparent yellow resin to haft sharp points on arrows and fishing
spears and as a sealant for their pottery containers. Encelia is regarded as a
medicinal plant by the Seri, O'Odham and Cahuilla people. The branches can be
cooked down to ashes to produce a gummy glue that can be applied to a loose
tooth for support. The Cahuilla would also apply this gummy resin to their chest
and joints to relieve pain. Early Spanish missionaries enjoyed burning the resinous
crystals that exude from the stems. They liked the smell and regarded this plant as
a form of incense. For this reason, the Spanish settlers in California called this
shrub, ‘incienso.’ I find that10% Encelia resin makes for a pretty effective anti-
fungal when placed in a salve base, it works even better if we also add about 10%
Creosote (Larrea tridentata) to the preparation...and the salve smells amazingly
like a rainy day in the desert, and maybe, just maybe, one's feet can smell the same.
Monolaurin (glycerol monolaurate or GML) is the monoester formed from
glycerol and lauric acid. Lauric acid is a naturally occurring 12-carbon medium-
chain saturated fatty acid. The richest dietary source of GML is coconut oil but it is
also found in human breast milk and palm kernel oil. The body has the ability to
convert lauric acid into GML by enzymatic activity, it is not known how much this
process actually occurs in vivo. Chemically, GML is a surfactant, it has been used
for decades as a dispersant and emulsifier in the cosmetics industry and food
industry. The antimicrobial activity of fatty acids and their esters is well known,
with chain length, unsaturation (cis, trans), and functional groups all being
variables that affect this activity. GML antimicrobial activity appears to be
primarily by disruption of lipid bilayers, being up to 200 times more effective than
lauric acid alone. Monolaurin first became available as a nutritional formulation in
the mid-1960s and has some impact on mocrobial growth in the body, I find it a
decent anti-fungal that doesn't create liver issues for most people.19 Orally dosed at
1 gm, 1/4 tsp, twice a day.
Changing the ecology of the foot and shoe can be profound, the addition of a
tablespoon or so of baking soda to the shoes every two weeks or so helps reduce

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foot odor and the level of fungal presence, it is not great for shoes that begin to
exhibit a white crystalline structure on the outside of the shoe...which washes
away. Spending more time with one's feet not confined to the sweaty interior of a
heavy shoe is also very helpful.
Modern footwear is not very conducive to healthy feet for several reasons.
Consider that one lesson to be learned from the ancient Chinese foot-binding
practice is that feet can and will conform themselves to all kinds of crazy
conditions. Many of the structural issues that we will discuss in foot pathology can
be directly related to footwear, what we do to our feet every day is what our feet
will adapt to, every day. The good news about this aspect of our developmental
anatomy is that structural defects can also be changed with consistently applied
support and strategic pressure distribution. If we could magically make everything
in a body invisible except the collagen network, we would see dense leathery mesh
in the bones, cartilage, tendons, and ligaments. We would see a very loose fascial
mesh in the breast, the cheek, and the pancreas. Each muscle would be surrounded
and invested with a looser (but still structurally strong) fascial network. Every bone
would have a tough plastic-like fascial wrap layered around the outside. Every
organ would be invested and then bagged in a sack of fascia. Only the open tubes
of the digestive, respiratory, and lymphatic system would be relatively free of this
fascial net, that is really one giant membrane. It is a neuro-myofascial web that acts
as a whole and serves us from second-to-second within gravity and the other forces
surrounding and affecting us, it is also vastly communicative, detecting and
transmitting sensory information from the surrounding environment and
facilitating a movement of internally derived communication in response to the
constant input from the external world. Structure without function is a corpse. But
function without structure is a ghost. Fascia is part of a vastly complicated
architecture that follows different rules than the human made architecture that we
are accustomed to observing; fascia responds locally and systemically, and to
understand this systemic response at its most basic level, we invoke a concept
known as tensegrity, a structural geometry that best describes the dynamic
architecture of the human body.
Tensegrity is a word coined by Buckminster Fuller in the 1960’s as a
combination of ‘tension’ and ‘integrity’, after seeing the highly original sculptures
of Kenneth Snelson, to indicate a structural integrity derived from the balance of
tension between the elements of a system, not through compression forces.
Biotensegrity, a term coined by the orthopedic surgeon, Dr. Stephen Levin, is the
application of tensegrity principles to biologic structures, including muscles,
tendons, ligaments, bones, fascia, and even into the fundamental building blocks of
life, cell membranes and the microscopic cytoskeletal elements. The human
musculo-skeletal system is a synergy of connective tissues from microscopic

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elements to macroscopic anatomy. Superficially, the muscles and other softer

connective tissues provide continuous tension, and the bones represent the
discontinuous compression elements, the whole system is made exponentially
stronger and more flexible by the coordinated efforts of these tensioned and
compressed parts. Fascial continuity suggests that the myofascia acts like an
adjustable tensegrity around the skeleton, from the fascia connected to the inner
aspects of the skull to the plantar fascia in the soles of the feet – a continuous
inward pulling elastic tensional network, with the bones acting like the struts in a
tensegrity model, pushing against the stabilizing elastic bands20. If any part of this
system becomes deformed or distorted, relative to the whole network, innumerable,
tiny, compensatory changes take place to ensure that the entire body remains
posturally stable. Slow and intentional alterations in the anatomy, as we see in
serial casting, therapeutic injections and certain kinds of therapy, allow for an
efficient enough compensation on the part of the rest of the network that symptoms
like pain only occur after significant tissue remodeling has taken place. Acute
injury seldom allows adequate time for compensation and presents with rapid onset
of pain. Pain is a vast subject that we will address later in this discussion, but, right
now, we can recognize that the subjective experience of pain often plays a very
significant role in the tissue remodeling process. If holding a particular position
creates the experience of pain, one tends not to hold that position, and, over time,
there is a certain reduction in the ways that a body can comfortably ‘hold itself’,
which then impacts the ability of the body to perform certain activities potentially
relevant to daily life. We understand some of the underlying mechanisms that are
involved in this endless compensating network through the work of two physicians
from the 1800’s, Wolff and Davis.
Julius Wolff (1836–1902) was a German anatomist and surgeon who
recognized that bones in a healthy person or animal will adapt to the loads under
which it is placed. If loading on a particular bone increases, the bone will remodel
itself over time to become stronger to accommodate that type of loading. What he
clarified was that the internal bony architecture of the trabeculae adapts first,
followed by secondary changes to the external cortical portion of the bone,
becoming thicker or thinner, more or less dense to accommodate changing
structural forces. It is really important to note that if the loading on a bone
decreases, the bone will become less dense and weaker due to the lack of the
stimulus required for continued remodeling21. Henry Gassett Davis (1807-1896)
received his MD from Yale and became an orthopedic surgeon after growing up
with a sister who had a difficult case of scoliosis during childhood. He founded
the “traction” school of orthopedic surgery, created the first splint for traction and
protection of the hip joint, and is known for his work in studying soft tissue
adaptation. His findings on soft tissue remodeling paralleled Wolff’s ideas on bone

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remodeling in that he proposed the idea that soft tissues heal according to the
manner in which they are mechanically stressed:
"Ligaments, or any soft tissue, when put under even a moderate degree of
tension, if that tension is unremitting, will elongate by the addition of new
material; on the contrary, when ligaments, or rather soft tissues, remain
uninterruptedly in a loose or lax state, they will gradually shorten, as the
effete material is removed, until they come to maintain the same relation to
the bony structures with which they are united that they did before their
shortening. Nature never wastes her time and material in maintaining a
muscle or ligament at its original length when the distance between their
points of origin and insertion is for any considerable time, without
interruption, shortened”
Henry Gassett Davis, “Conservative Surgery” Appleton & Co., NY, 186721.
The fascial structure responds to changes in mechanical loading.
Fundamental mechanical properties adapt over long periods of use/disuse as a
result of biochemically mediated micro-structural changes at the level of the
collagen fibers. Tissues that have lost their original strength due to extended
periods of inactivity can regain most of their mechanical properties through
gradual and consistent re-loading over a 6 to 8-week period of time. However,
excessive loading during the recovery process may lead to material failure, i.e.
tearing of fibers, rupturing of membranes. Too often, the pattern that the people
that I see fall into is that they have long periods of time with relative inactivity,
then spurious bouts of exercise and they get injured because they are exceeding the
physical capacity of the involved tissues, new injury causes another reduction in
activity, with further atrophy of the uninjured structures, so that, once full activity
resumes, something else is injured or recovering. They might ride this roller
coaster of activity/injury for years before they acquiesce into a full-time sedentary
existence. We accommodate to the most comfortable existence that we can, if we
aren’t intentionally pushing our physical boundaries and maintaining a high level
of free and painless movement, we are allowing the encroaching physical
limitations of age to reduce the breadth of life that we get to experience in a pain-
free manner. There are metabolic ramifications to this situation that are far
reaching and include diabetes and heart disease, the deadliest diseases in our
country, and products of a sedentary lifestyle. The greater point is that the physical
body is constantly remodeling itself to best suit the presenting situations of life. We
can be too sedentary and lose the ability to be more vigorous in life, or we can be
constantly overloading and injury prone. The body can shift and adapt
immeasurably, given enough time and the right resources, we can teach/train a
body to do just about anything we desire.

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Serial casting is a medical technique that utilizes a series of casts to

gradually stretch and realign muscles and soft tissues, often to improve range of
motion and reduce muscle tightness. Davis's Law, which states that soft tissues
model along the lines of stress, describes how serial casting works. By applying a
series of casts that progressively stretch the tissues, serial casting leverages Davis's
Law to encourage soft tissue adaptation and remodeling. There are a number of
tools that are beneficial while engaged with serial casting processes, our clinic
offers ultrasound guided injections of hyaluronidase and collagenase, to help
breakdown scar tissue and lengthen shortened structures, we also provide PRP,
platelet rich plasma, which helps shorten structures that are too lax. There are a
number of items that we will include in those injections and other measures that we
will apply as well, including Extracorporeal Shockwave Therapy (ESWT), a non-
invasive form of treatment that was developed from ESWL (extracorporeal shock
wave lithotripsy) and is based on a unique set of pressure waves that break down
fibrous scar tissue, stimulate metabolism, enhance blood circulation and accelerate
the healing process22.
Serial casting can serve as a critical intervention for conditions that impair
movement and muscle control such as cerebral palsy, spina bifida, and muscular
dystrophy. Serial casting can help preserve mobility and delay the progression of
atrophy while stretching contracted muscles and reducing spasticity, helping to
improve range of motion and prevent further deformities in the affected limbs. It is
also a type of foot-binding and part of our job is to make it as comfortable as
possible, and hard, heavy cast material is not comfortable. There are less
cumbersome options, and they are well worth considering; Turtle Brace is a
company that makes a wide range of heat moldable bracing/casting materials, and
they install a zipper for easy removal. You can mold and remold the material an
absurd number of times and it still works--unless you get it too hot. Progressive
Gaitways/Billi Cusick in Telluride, Colorado is a phenomenal resource for training
in serial casting, they have introductory videos on their website, and they sell the
turtle braces23. If you have any interest in this domain of medicine, please explore
what Billi has to offer, she is brilliant and her training program is superb.
Stress and tension are many times related to one another; as we feel
“stressed” we tend to become more tense. We then tend to hold our tension in
particular areas of our physical body—many of us in our neck and shoulders,
others in the thoracic or lumbar spine areas. One of the basic conceptions of
muscle physiology is that it takes energy to relax a muscle. The blood flow into
and out of a muscle is what allows delivery of energetic molecules into the muscle
tissue, allowing for a relaxation response; this is one of the reasons why, when a
body dies, every muscle ends up contracting and the body assumes Rigor Mortis.
Ironically, as a muscle contracts it literally “wrings” the blood out of itself,

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relaxation allows better blood flow back into the structure. Progressive tension in a
muscle compromises its own blood flow which, then, causes more tension, often
leading to a cycle of spasticity that can be difficult to break up. The longer a tissue
stays spastic, the more likely they are to develop fibrous bands of scar tissue in
muscles that are depriving themselves of blood flow, and the sensation of pain
creates an additional tension in the surrounding region. The repeated
contraction/relaxation cycle involved in a regular exercise regimen can be
profoundly effective in re-establishing appropriate blood flow into spastic
muscular structures. Well placed shockwave therapy, massage, hydrotherapy,
therapeutic exercise and a topical agent to improve blood flow into and out of the
area that is remodeling can be very helpful and might represent a base of
intervention for many foot problems.
Creams are essentially botanicals mixed into a cream base. There are many
bases available and there are both water and fat-soluble forms. An excellent
lipophilic cream base can be made from whipped safflower or sunflower oil. For a
hydrophilic cream base we use a cetearyl alcohol to emulsify beeswax and
macadamia nut oil . Hydrophilic creams are fun and easy to make, I usually custom
make them for specific patient problems, most of the time for musculoskeletal and
neurological pain syndromes. We start with a base of 1 liter of macadamia nut oil,
make it hot, I like a double boiler, add 300 gms of beeswax and 175 gms of
emulsifying wax (cetearyl alcohol). I have had wonderful successes with peripheral
neuropathy and CRPS (complex regional pain syndrome) with the following cream
recipe:
1 oz. Aconitum napellus tincture
1 oz. Veratrum viride tincture
1 oz. DMSO
Mix into 100 gms cream base very slowly while stirring with a wooden tongue
depressor.
Aconitum napellus-Monkshood is abundant in the mountainous woodlands
of various parts of Europe, Asia, and North America, especially along the Pyrenees
in France, the Himalayas, and throughout Siberia. It is a high altitude plant,
growing at heights of 10,000 to 16,000 feet. The medicinal part is considered to be
the root. This is one of the most toxic botanicals that are still present in the
formulary of botanical medicine. It has proven itself of great enough value that it is
still present in modern clinical practice. Even so, I can’t emphasize enough that
this one of those low dose botanicals, even for topical use. This plant contains
several di-ester alkaloids, including aconitine, mesaconitine, hypaconitine, N-
desethyl aconitine, and oxoaconitine. These compounds increase the membrane
polarity of nerve cells for sodium ions and slow repolarization of the nerve. The
details of this process are a source of fascination for me. Recall that the ability of a

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nerve cell to create a charge across its membranes is essential to its role of
transmitting electrical current through the nerve itself. The formation of the charge
is dependent on sodium/potassium pumps being able to pump sodium to the
outside of the cell, creating a relative positive charge on the outside of the nerve
and a relative negative charge on the inside. When a current is passed through the
nerve, voltage gated sodium channels open up and the sodium floods into the cell,
releasing electrical energy that perpetuates the signal that is being sent. After the
current has passed, the body begins to set up the same electrical gradient across the
membrane for the next time that an action potential is needed. When the di-ester
alkaloids in Aconite are present, the membrane becomes more permeable to
sodium ions, initially this has a stimulating effect, the sodium is rushing into the
cell as if there were a message being sent and a depolarization of the membrane
occurs. When the action potential has been fired, the nerve would normally begin
to repolarize the membrane by pushing sodium back out of the cell but, because the
cell membrane is now more permeable to sodium, they just slip back inside and the
cell can’t repolarize. This has the practical effect of paralyzing/anesthetizing that
nerve if it is a sensory nerve, which can be great for neuralgias and neuropathies. It
has the problematic effect of doing the same thing to the vagus nerve and the
cardiac innervation when it is in too great an amount in the system and that can kill
a person24.
Veratrum viride-Green Hellebore is a plant that was much revered by the
eclectics at the turn of the century, they literally wrote volumes about it. It contains
several steroidal alkaloids, including some solanidanes, isorubijervine, rubijervine,
germitrin, veratrine and protoveratrine. Maude Grieve feels that because of its
potential toxicity, its only justifiable use is as a topical an anodyne counterirritant,
especially for neuralgias. Ellingwood reports the first signs of poisoning to be
sneezing, lacrimation, salivation, vomiting, diarrhea, burning of the mouth and
throat, and hypotension. This herb provides a consistent reduction of blood
pressure and slowing of the pulse, this is thought to be primarily due to the action
of the alkaloid germitrin25. It is also indicated for topical use as a local anesthetic
and counterirritant. I have used this herb topically for neuropathies, neuralgias and
sciatica, often mixed into a liniment or a cream with equal parts of aconite, lobelia
and DMSO, ten to twenty drops applied to the area. I have yet to see anyone get a
toxic effect from this plant. With careful dosing and conscientious prescribing, it
can be a wonderful adjunctive botanical agent.
Topically applied tropane alkaloids can be very helpful in spastic conditions
as is Capsicum, not just as a source of pan relieving capsaicin, but also because it
helps improve blood flow. Agents that we find helpful to include for those going
through serial casting and struggling with spasticity include, Datura, Atropa,

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Capsicum, Lobelia as well as Piroxicam (as an anti-inflammatory), Pentoxifylline

(a blood flow agent) and Baclofen (a topical anti-spasmodic).
Atropa belladonna-Deadly Nightshade lives in the shadowy recesses of our
culture, even people who have no knowledge of botanical medicine have heard
about this one, usually in the context of scary things that can kill you. We find the
earliest human usage of Atropa belladonna as seeds in the living and ritually used
areas of a village dated to 4500 BCE in Romania. It is probably the most famous of
the “witches’ herbs” and has a tremendous amount of European folklore associated
with it. Maude Grieve reminds us that according to old legends, the plant belongs
to the devil who goes about trimming and tending it in his leisure and can only be
diverted from its care on one night in the year, Walpurgis, when he is preparing for
the Witches’ Sabbath. The apples of Sodom were thought to be related to this plant
and the name Belladonna is given to it because at certain times it takes the form of
an enchantress of exceeding loveliness, whom it is dangerous to look upon. It is
more likely that the name derived from the use of the juice of the plant by Italian
ladies to give their eyes greater brilliance by dilating them26. Ophthalmologists use
the alkaloid atropine, originally derived from this plant, to perform a similar
function today. The thing about legendary plants with reputations as poisons is that
they tend to freak people out, especially insurance agents trying to parse out
malpractice insurance needs so that the medical school can continue to send
students to your clinic for off-site training. Yet, this has been one of the most useful
medicinal plant allies that humans have ever employed and indispensable for my
botanical medicine practice, it is no exaggeration to say that we use this plant and
its botanical cousins on a daily basis in our clinic.
The leaf and the root of this plant are used medicinally; the different plant
parts have slightly different alkaloids with varying qualities, leaf and root are more
consistent and predictable in concentration. The chief alkaloid throughout the plant
is L-hyoscyamine, which transforms to some degree into atropine (a racemic
mixture-D, L-hyoscyamine) with drying. Also present are other tropane alkaloids
like apoatropine, scopolamine, and tropine. The tropane alkaloids are competitive
antagonists of the neurotransmitter acetylcholine, the original anticholinergics
(even though the receptors are named after muscarine--fungal politics, they always
win in the end). Essentially these compounds bind to the same receptor as
acetylcholine, keeping that neurotransmitter from doing its job while exerting an
opposite effect at the receptor. This effect is limited to the muscarinic receptors, not
so much to the nicotinic receptors. What this means from a practical clinical
perspective is that this plant is a specific antispasmodic and sometimes perfect for
tight and sore muscles when rubbed in topically. Fibromyalgia patients do quite
well with such application, as do patients with dystonia from neurologic injury.
Felter refers to it as a remedy of power in the acute congestion of the kidneys, for

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this he recommends external application with a poultice over the kidneys as well as
internal dosing27. King’s American Dispensatory gives us, perhaps, the best
summation of belladonna toxicity, in large doses it acts upon the cerebrospinal
system with a dilation of the pupils, far-sightedness with obscurity of vision
leading to absolute blindness, visual illusions (especially of phantasms), ringing in
the ears, numbness of the face, giddiness and delirium. The mouth and throat
become dry with difficulty in swallowing and articulating, constriction about the
throat, nausea, vomiting, swelling, and redness of the skin28.
The genus Datura (Solanaceae) contains nine species of medicinal plants
that have held both therapeutic effect and cultural significance throughout history.
Although Datura contains mostly tropane alkaloids (such as hyoscyamine and
scopolamine), indole, beta-carboline, and pyrrolidine alkaloids have also been
identified. Datura is known as the Holy Flower of the North Star by the Chinese
because of a Taoist legend that maintains that Datura metel is one of the
circumpolar stars and that envoys to earth from this star carry a flower of the plant
in their hand. Throughout the entire world, Datura has had a long history as a
medicine and sacred hallucinogen. Like belladonna, it owes much of its
physiologic potency to the presence of the tropane alkaloids hyoscyamine,
atropine, and scopolamine. It shares anticholinergic and parasympatholytic effects
with belladonna. Maude Grieve, in her classic text on botanical medicine, writes
that Datura is employed in all of the conditions for which belladonna is more
commonly used, but acts much more strongly on the respiratory organs. It has a
special reputation as an effective agent for spasmodic asthma26.
Many indigenous people use Datura for its visionary properties, valuing it
for diagnosis, healing and intoxication. Upon learning from these visions the cause
of a particular disease, a proper prescription can be applied to the case. The
Chinese herbalist Li Shih-Chen, in 1596, writes, “According to traditions, it is
alleged that when the flowers are picked for use with wine while one is laughing,
the wine will cause one to produce laughing movements; and when the flowers are
picked while one is dancing, the wine will cause dancing movements. I have found
out that such movements will be produced when one becomes half-drunk with the
wine and someone else laughs or dances to induce these actions.” The Aztecs knew
the species D. stramonium and D. innoxia and named them as “Tlapatl” and
“Mixitl,” respectively, the flowers and the seeds of the plant were used externally
for the treatment of skin rash of the face and orally ingested for the treatment of
neurological conditions. It is an important anesthetic when consumed along with
cannabis in wine29. The earliest documentable human uses of Datura occur as
debris in pottery samples from Western Mexico dated to 1400 BCE and to 1600
BCE from hair samples recovered from the Es Carritx burial site on the island of
Menorca, Spain30.

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Capsaicin (trans-8-methyl-N-vanillyl-6-nonenamide), is a fat-soluble, oily

substance derived from Capsicum spp, pepper plants, and has been used in
traditional medicine for centuries to treat pain. Topical application of capsaicin
creates an initial burning sensation as it binds to a highly selective vanilloid
receptor subtype 1 (TRPV1), a non-selective cation channel that responds to
noxious stimuli such as pH extremes, temperature extremes and chemical irritants.
The neuropeptide substance P (SP) is expressed in primary sensory neurons and is
commonly regarded as a “pain” neurotransmitter as it activates the neurokinin-1
(NK-1) receptor and potentiates activity of vanilloid receptor subtype 1 (TRPV1),
which is co-expressed by nociceptive neurons. SP functions as an important
neurotransmitter involved in the hypersensitization of inflammatory pain, using it
up through repeated local applications of capsaicin prevents the local pain stimuli
from reaching the brain. In the area of application, tissue sensitivity to pain
decreases, and the pain threshold increases. Several studies have focused on the
use of capsaicin as a topical analgesic for pain that is not responsive to traditional
painkillers, such as non-steroidal anti-inflammatory drugs (NSAIDs), opiates, and
paracetamol. Topical capsaicin has a proven effectiveness in the treatment of
chronic pain conditions, including rheumatological diseases and diabetic peripheral
neuropathy, it also acts as a counter-irritant, facilitating delivery of other agents in
a topical application.
Piroxicam is a nonsteroidal, anti-inflammatory, and analgesic agent. It is a
fat-soluble agent that creates an analgesic/anti-inflammatory effect by inhibiting
the cyclooxygenase (COX) family of enzymes. It is able to made into a topical
preparation which improves specificity of application over oral dosing and reduces
the frequency of harmful adverse gastrointestinal events. The direct application of
piroxicam and capsaicin to a painful area reduces the amount of active drug
passing into the systemic circulation, thus facilitating safer analgesic treatment
without systemic effects. Such therapies are very useful for the treatment of direct
trauma, especially superficial pain resulting from events such as sprain, strain,
muscle injury, and tendon trauma. NSAID use has a destructive impact on cartilage
regeneration by inhibition glycosaminoglycan synthesis, so also contribute to drier
joints. A notable exception in this class of medications is piroxicam, it has proven
to have no detrimental effect on cartilage metabolism31, it is a convenient addition
to a topical cream at doses of 1-3%.
Pentoxifylline is a methylxanthine derivative conventionally used for the
treatment of intermittent claudication, it is a vasoactive agent, increasing tissue
perfusion of blood via several mechanisms of action such as increasing erythrocyte
and leukocyte elasticity, preventing platelet aggregation, and providing a
vasodilatory effect. It also has anti-inflammatory and antioxidant properties.

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This agent is really useful topically for the treatment of pressure injury. Several
studies have shown that topical pentoxifylline could prevent pressure injury, reduce
the severity of existing injury, or accelerate the wound healing process32. I find this
a useful addition, on the order of 3% in a topical cream for use in between casting
sessions for those doing serial casting, the pentoxifylline toughens the skin and
prevents some of the pressure injury that can become problematic for future
casting applications
Baclofen Baclofen (β-parachlorophenyl GABA), is a GABA-B agonist that
acts as a muscle relaxer and an antispasmodic agent that inhibits spinal reflexes,
reducing spasticity and improving both passive and active movement. Baclofen is
used to treat muscle pain, spasms, and stiffness in people with multiple sclerosis or
spinal cord injury or disease. Baclofen is given intrathecally (directly into the
spinal cord), orally and applied topically. Side effects include ataxia, central
nervous system depression and seizures. The initiating dose is 2.5-5 mg/day which
can often rise to the higher doses of 20-60 mg/day depending on age and size.
Baclofen must be weaned slowly to avoid withdrawal symptoms, which include
seizures, irritability, increased spasticity, and mental confusion. I find that a 10%
reduction of the current dosage every 4-7 days is a tolerable weaning schedule for
most. Topical baclofen, applied as a 3% concentration in a cream that will also
contain tropane alkaloids, does work somewhat as a local muscle relaxer, we use it
as such 2-3 times a day.
Amanita muscaria, the fly agaric, is a relatively small 'gill-bearing’
toadstool, growing to between 5 -12cm tall. Early in its fruiting, it is covered by a
white membranous veil, which tends to rip as the stem pushes up and the bright red
cap expands. The remains of the veil skirt the stem and also leave white, wart-like
flakes covering the cap, though these are sometimes washed away by heavy rain.
As it matures, the cap opens up like an umbrella, forming a depression around the
center. Its red skin can easily be peeled off. The stem is bulbous at the base and
discontinuous with the cap. The mushroom flesh is white and has no particular
smell when fresh. Upon drying it develops an unpleasant musky-acrid smell, which
erroneously has been claimed to ward off flies. In North America a closely related
species, A. americana is also referred to as Fly Agaric. Its' cap tends to be more
yellow-orange. Less similar and more toxic in nature is A. pantherina, whose cap
tends to be more yellow-brownish and its stem more slender. All these species are
generally regarded as poisonous and even deadly.
In the mid-1960's the entheogenic compounds of Amanita muscaria were
positively identified as ibotenic acid and muscimol, its decarboxylized derivative.
Research concluded that the actual psychotropic effect is most likely produced by
muscimol, since 50-100 mg of ibotenic acid produces the same effects as 10-15 mg
of muscimol. The symptoms of inebriation are characterized by muscle twitching,

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dizziness, visual distortions (macropsia and micropsia) and altered auditory

perception. The potency of individual mushrooms tends to vary widely, their
power being modified by environmental factors, such as seasonal variation, the
weather, the phase of the moon and the pH level of the soil. The Kamchatcals from
northern Siberia, who have a long history of Fly Agaric use, maintain that those
that desiccate while still in the earth and remain attached to the stalk tend to have a
greater psychotropic effect than those that are picked fresh and strung up to dry.
They also claim that the smaller ones, whose bright red caps are still covered with
many white spots, are said to be stronger than the larger ones with paler caps and
fewer spots. Those picked in August are said to be the strongest. For topical use, it
is made into a 1:3 tincture and applied topically on the order of 2-3 drops to an area
in pain, or, more commonly, added to a lotion or pain cream. Using the basic
recipe for a topical cream outlined above, the added tincture preparation might
look like:
1 oz. Lobelia acetract
1 oz Amanita muscaria tincture
1 oz Atropa belladonna tincture
1 oz DMSO
The Amanita is specific for swollen, inflamed nerves, like an irritated sciatic nerve,
peripheral neuropathy or neuralgia33. I have seen it work very rapidly to bring
relief that wasn't forthcoming by other means.
Plantar fasciitis is the most common cause of heel pain presenting in the
outpatient setting. Estimates show that approximately 1 million patient visits
annually are due to plantar fasciitis and this condition accounts for about 10% of
runner-related injuries and 11% to 15% of all foot symptoms requiring professional
medical care. Plantar fasciitis occurs in about 10% of the general population, with
83% of these patients being active working adults between 25 and 65 years. The
peak incidence is among the general population of 40 to 60 years. Plantar fasciitis
may present bilaterally in a third of the cases. In addition, a higher prevalence of
plantar fasciitis was observed in women compared to men, in those aged 45 to 64
versus those aged 18 to 44, and in those with a body mass index >25 kg/m2. Some
literature shows that runners' prevalence rates are as high as 22%. Plantar Fasciitis
presents as inflammation on the bottom of the foot that leads to heel and/or arch
pain. A variety of foot injuries or improper foot mechanics can lead to plantar
fasciitis. Treatments range from icing and foot exercises to the prescription of
dynamic orthotics to correct the foot position and help alleviate pain. Specifically,
we address the patient's gait, their footwear, and their baseline level of
inflammation. A cream consisting of Capsicum/Datura/Lobelia and DMSO can be
additionally loaded with 2% piroxicam, and 3% Pentoxifylline and applied to the
affected foot twice a day and will reduce the inflammatory cascade, reduce the pain

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and get better blood flow into and out of the sole of the foot. In many cases, the
strain/sprain pattern in the foot has been an extension of the distance from the ball
of the foot and the heel, the common phrase, "fallen arches", is not necessarily
appropriate but the process is the same. As the tension in the fascial band, which
extends into all five metatarso-phalangeal joints and then consolidates at the inside
of the calcaneus (heel), increases, the fascia becomes overstretched and damaged,
it is not uncommon to have heel spurs develop at the attachment of the plantar
fascia with the heel. A dynamic orthotic can be very helpful--this is not a custom,
static orthotic, this is a platform that approximates the arch of a foot and
compresses down with each step and then recoils back to its original shape after, it
works the muscles of the feet and ankle in a way that allows a reconstitution of the
falling arch. Extracorporeal shockwave therapy is really a great intervention for
this condition, providing pretty rapid relief. Plantar fascitis also responds to
hydrotherapy, the affected limb can be treated with alternating hot and cold baths,
1 minute cold and 4 minutes hot with 4-10 alternations--start with not-so-hot and
not-so-cold for only a few alterations until one gets used to the increase in blood
flow and gradually increase the temperature differential and number of
alternations. Wet sock-type of warming compresses are also very helpful, usually
applied before bed, a loose-fitting cotton sock is made damp and placed on the
affected limb, a loose wool sock is placed over the top of the damp cotton sock. As
the patient sleeps, the body tries to dry the moisture and increases blood flow into
and out of the region, which generally reduces pain and swelling while allowing
the fascia to recover. Heel spurs are growths of bone on the underside, forepart of
the heel bone. Heel spurs occur when the plantar tendon pulls at its attachment to
the heel bone. This area of the heel later calcifies to form a spur, it is highly
associated with a shifting arch and stretching of the plantar fascia. The shockwave
can pulverize the spur, we do an ultrasound guided barbotage where we will
identify the spur, treat the area with shockwave and then, under ultrasound
guidance place a needle at the site and suck the debris into a syringe. It is very
satisfying.
A bunion, or hallux valgus, can be seen as a failure of the metatarsal arch,
specifically at the first metatarsal joint. When the arch collapses or weakens, it can
lead to a misalignment of the big toe and the formation of a bunion. This
misalignment puts increased pressure on the first metatarsophalangeal (MTP) joint,
contributing to further development of the bunion and deterioration of the
joint. Bunions do run in families, because foot type (shape and structure) is
hereditary, and some types are more prone to bunions than others. Low arches, flat
feet, and loose joints and tendons all increase the risk. The shape of the metatarsal

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head also makes a difference: if it's too round, the joint is less stable and more
likely to deform when squeezed into shoes with narrow toes. High heels can
exacerbate the problem because they tip the body's weight forward, forcing the toes
into the front of the shoe and may explain why bunions are 10 times more common
in women than in men. People in occupations such as teaching and nursing, which
involve a lot of standing and walking, are susceptible to bunions. So are ballet
dancers, whose feet suffer severe repetitive stress. Women can develop bunions
and other foot problems during pregnancy because hormonal changes loosen the
ligaments and fascia and body weight increases precipitously. Ultimately, cowboy
boots and high heels are primary causes of bunions. Surgery is frequently
performed to correct the problem, however, surgery leaves scar tissue behind
which becomes harder and more fibrous over time and can complicate the
situation. There are a lot of similarities between the cause of plantar fasciitis and
the cause of bunions, the plantar fascia is a response to the longitudinal stretching
of the fascia that supports the major arch of the foot, in a bunion, there is a latero-
medial stretch of the fascia of the metatarsal arch, allowing a migration of the first
joint away from the other four. Structurally, the metatarsal arch needs to be
supported so that the fascia can shrink back to a more normal tension, this means
wearing the right kind of shoe, and possibly employing a dynamic orthotic, as
mentioned earlier for plantar fasciitis. I really appreciate the movement toward
barefoot shoes that has happened over the past two decades, assuming a person can
get their foot into a pair of shoes that has a slot for each toe, they can be beyond
helpful to reduce or reverse a bunion formation. At the very least, shoes should
have a wide, flexible sole to support the foot and enough room in the toe box to
accommodate the bunion. Some good choices are sandals, athletic shoes, and shoes
made from soft leather. Shoes with a back should have a sturdy heel counter to
keep the heel of the foot snugly in place. You may be able to reshape narrow shoes
with stretchers that make room in the toe box for the bunion. Low to no heel is
best. I generally talk to people about their footwear, a dynamic orthotic and some
Kinesio-tape...if the can comfortably place a layer of K-tape around the bunion
joint and the rest of the foot--not tight but enough to provide support so that the
fascia is able to start shrinking, that will help over the long-run. Anti-inflammatory
topical agents like the aforementioned creams with piroxicam and pentoxifylline

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can be really helpful, alternating hot/cold foot baths, wet socks, oral dosing of
Boswellia and Turmeric can also be very helpful.
Hammertoe is very often a manifestation of the same fascial stretching and
tendinopathy related to heavy stressors placed on the feet without appropriate
support...and to be fair, in many instances no support is better than ill-placed/ill-
fitted support. Hammer toes tend to stem from muscle imbalance, tendon issues
and fascial distortion and the toe is forced into a claw-like position. Hammertoe
can affect any toe, but most frequently occurs to the second toe, especially when a
bunion slants the big toe toward and under it. Selecting shoes and socks that do not
cramp the toes may help alleviate pain and discomfort. Better foot support is often
the key to hammer-toes, as is frequent hot/cold foot baths with epsom salts. Our
clinic uses musculoskeletal ultrasound guided injections and, often, we can address
fascial restrictions and tendinopathies very effectively with that tool. The measures
that we discuss for plantar fasciitis and bunions is apropos here as it is really a
different manifestation of the same pathology.
Ingrown toenails are those nails with corners or sides that dig painfully into
the adjacent tissues of the toe. Ingrown toenails are usually caused by improper
nail trimming, but can also result from shoe pressure, injury, fungal infection,
heredity, and poor foot structure. Women are more likely to have ingrown toenails
than men. The problem can be prevented by trimming toenails straight across,
selecting proper shoe styles and sizes, and responding to foot pain in a timely
manner. In acute situations, a V-notch can be cut into the offending nail and the
sides will be drawn in while the nail growth shifts to cover the exposed bed.
Neuromas are enlarged benign growths of nerves that can occure anywhere
in the body. Morton's neuroma is a particular type that occurs most commonly
between the third and fourth toes of the feet and is caused by tissue rubbing against
and irritating the nerves. Pressure from ill-fitting shoes or abnormal bone structure
are common causes of this condition. It is highly associated with plantar fasciitis,
bunions and hammer toes, also associated with bad foot wear and the breaking
down of feet that lived their lives in a constraining box, this is the neurological
manifestation of that breakdown. The topical applications previously discussed can
be very helpful, as can ultrasound guided injections of PRP, Procaine, TB4 and
collagenase.

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Sulbutiamine, fursultiamine, and benfotiamine are fat soluble forms of

thiamine (vitamin B1), they were developed in Japan in an effort to develop more
clinically useful thiamine compounds. Thiamine is normally unable to diffuse
across plasma membranes because it has a positively charged thiazole moiety, it
must be actively transported across plasma membranes. Structurally, sulbutiamine
and benfotiamine are derived from allyl-thiamine and consist of lipophilically
modified thiamine molecules, which, allows them to cross the blood-brain barrier
more readily than thiamine and increase the levels of thiamine and thiamine
phosphate esters in the brain and peripheral nerves. Sulbutiamine and fursultiamine
are some of the only truly effective compounds used to treat asthenia, mental
fatigue commonly associated with neurologic injury and one of the most persistent
quality of life issues in patients so afflicted, it appears to have a positive impact on
memory, reduces psycho-behavioral inhibition, and improves erectile dysfunction.
At therapeutic dosages, 30-50 mg/day for fursultiamine and 200 mg/day for
sulbutiamine, there are few reported adverse effects. Benfotiamine is more
specifically anti-inflammatory in the peripheral nervous system and is helpful in
reducing the incidence of peripheral neuropathy, neuromas and speeding the
healing of damaged nerves as in sciatica, MS, and tissue trauma. Dosages of 200-
400 mg/day are usually effective.
Our feet are a precious appendage that, in the words of the Buddhist monk,
Thich Naht Hahn, 'allow us to kiss the earth with every step', they are our source of
'grounding' and when they are pain free and working well, we are virtually
unstoppable, when they are painful and not working well, we can hardly get to the
bathroom. Few parts of us have more impact on our mobility and our sense of self-
confidence and competence than our feet.

References:
1. Macho, Gabriele. (2018). Referential Models for the Study of Hominin
Evolution: How Many Do We Need?. 10.7551/mitpress/11032.003.0014.
2. Laitman JT. Evolution of the human foot: a multidisciplinary overview. Foot
Ankle. 1983;3(6):301-304.
3. Morton DJ. The Human Foot: Its Evolution, Physiology, and Functional
Disorders. New York: Columbia University Press; 1935.

240
2025 Medicines from the Earth The Foot - Proefrock

4. Lake NC. The Foot. London: Bailliere, Tindall and Cox; 1935.
5. Ko, Dorothy. Cinderella's Sisters: A Revisionist History of Footbinding.
University of California Press, 2005.
6. Li, Jing. Chinese Tales. In Donald Haase (ed.). The Greenwood Encyclopedia of
Folktales and Fairy Tales. Vol. I: A-F. Greenwood Press;2008. p. 197.
7. Carruthers, Amelia. Cinderella – And Other Girls Who Lost Their Slippers
(Origins of Fairy Tales). Read Books; 24 September 2015.
8. Andrew Lang, The Blue Fairy Book (London: Longmans, Green, and Co., ca.
1889), pp. 64-71.
9. Charles Perrault, "Cendrillon, ou la petite pantoufle de verre," Histoires ou
contes du temps passé, avec des moralités: Contes de ma mère l'Oye (Paris,
1697).
10. Althaus-Reid, Marcella MarÍa, 'Feetishism: The Scent of a Latin American
Body Theology', in Virginia Burrus, and Catherine Keller (eds), Toward a
Theology of Eros: Transfiguring Passion at the Limits of Discipline,
Transdisciplinary Theological Colloquia (New York, NY, 2007; online edn,
Fordham Scholarship Online, 10 Mar 2011).
11. Outen, Gemma. “The Women's Total Abstinence Union and periodical Wings,
1892-1910: a study of gender and politics.” (2017).
12. Fessler, D. M. T., Stieger, S., Asaridou, S. S., Bahia, U., Cravalho, M., de
Barros, P., et al. Testing a postulated case of intersexual selection in humans:
the role of foot size in judgments of physical attractiveness and age.
Evolution and Human Behavior, 33, (2012);147–164.
13. Patricia Buckley Ebrey. The Inner Quarters: Marriage and the Lives of Chinese
Women in the Sung Period. University of California Press, (1993); pp. 37–
39.
14. Mazo, Joseph H.. “Dance Is A Contact Sport.” Dance Research Journal 8
(1974): 23 - 24.
15. Carter, Keryn. Consuming the Ballerina: Feet, Fetishism and the Pointe Shoe.
Australian Feminist Studies,15, (2000);81-90.
16. Berkowtiz, Roger. translator of The Origin of the Work of Art, by Martin
Heidegger, originally presented as a lecture on November 13, 1935 at the
Kunstwissenschaftliche Gesellschaft in Freiburg. 2006 translation; pg. 17.

241
2025 Medicines from the Earth The Foot - Proefrock

17. Birnbaum J. E. (1990). Pharmacology of the allylamines. Journal of the

American Academy of Dermatology, 23(4 Pt 2), 782–785.
18. J.A. Maertens. History of the development of azole derivatives. Clinical
Microbiology and Infection;Volume 10, Supplement 1, 2004, Pages 1-10.
19. Lieberman S, Enig MG, Preuss HG. A review of monolaurin and lauric acid.
Altern Complement Ther. 2006;12(6):310–314.
20. Swanson, RL (2013). "Biotensegrity: a unifying theory of biological
architecture with applications to osteopathic practice, education, and
research-a review and analysis". The Journal of the American Osteopathic
Association. 113 (1): 34–52.
21. Ruff, Christopher & Holt, Brigitte & Trinkaus, Erik. (2006). Who’s Afraid of
the Big Bad Wolff?: ‘‘Wolff’s Law’’ and Bone Functional Adaptation.
American Journal of Physical Anthropology. 129. 484–498.
22. Auersperg V, Trieb K. Extracorporeal shock wave therapy: an update. EFORT
Open Rev. 2020 Oct 26;5(10):584-592.
23. https://gaitways.com/pages/cusick-center-for-learning-on-demand-courses
24. Şuţan NA, Paunescu A, Topala C, Dobrescu C, Ponepal MC, Stegarus DIP,
Soare LC, Tamaian R. Aconitine in Synergistic, Additive and Antagonistic
Approaches. Toxins (Basel). 2024 Oct 27;16(11):460.
25. Chandler CM, McDougal OM. Medicinal history of North American Veratrum.
Phytochem Rev. 2014 Sep;13(3):671-694.
26. Grieve, M, A Modern Herbal 1931, Reprinted by Dover Publications, NY, NY
1971.
27. Felter, Harvey Wickes, The Eclectic Materia Medica, Pharmacology and
Therapeutics 1922, Reprinted by Eclectic Medical Publications, Sandy, OR
1983.
28. Lloyd, John Uri. King’s American Dispensatory. 1898 Reprinted by Eclectic
Medical Publications, Sandy, OR 1983.
29. F.J. Carod-Artal. (2015) Hallucinogenic drugs in pre-Columbian Mesoamerican
cultures. Neurología (English Edition) 30:1, pages 42-49.
30.Guerra-Doce, E., Rihuete-Herrada, C., Micó, R. et al. Direct evidence of the use
of multiple drugs in Bronze Age Menorca (Western Mediterranean) from
human hair analysis. Sci Rep 13, 4782 (2023).

242
2025 Medicines from the Earth The Foot - Proefrock

31. Abdulkarim MF, Abdullah GZ, Chitneni M, Salman IM, Ameer OZ, Yam MF,
Mahdi ES, Sattar MA, Basri M, Noor AM. Topical piroxicam in vitro release
and in vivo anti-inflammatory and analgesic effects from palm oil esters-
based nanocream. Int J Nanomedicine. 2010 Nov 4;5:915-24.
32. Najafi E, Ahmadi M, Mohammadi M, et al. Topical pentoxifylline for pressure
ulcer treatment: a randomised, double-blind, placebo-controlled clinical trial.
J Wound Care 2018;27:495–502.
33. Ramawad HA, Paridari P, Jabermoradi S, Gharin P, Toloui A, Safari S,
Yousefifard M. Muscimol as a treatment for nerve injury-related
neuropathic pain: a systematic review and meta-analysis of preclinical
studies. Korean J Pain 2023;36:425-440.

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 2025 Medicines from the Earth HPV & Cervical Dysplasia - Stage

Botanical Support for

to HPV and Cervical
Dysplasia Disclosures
Katie Stage, ND RH (AHG), FABNG None
Medicines from the Earth Symposium 2025

This Photo by Unknown Author is licensed under CC BY-SA

Reflection
• Understand Human Papilloma Virus • Some of the research presented in this talk was
(HPV) done on HeLa cervical cancer cells (in vitro)
• Incidence and progression
• HeLa cells are the oldest cell lines used in research
• High and Low Risk types and were taken without knowledge or consent from
• Testing Henrietta Lacks, a black woman who died of

Objectives • Prevention
• Recognize the testing for and stages of
cervical dysplasia
cancer in 1951.
• HeLa cells were used to test the first polio vaccine,
have been sent to space, and have been used in
• Guidelines for testing many studies testing natural and pharmaceutical
treatments for humans and animals.
• Treatment approaches
• Of note, HPV is specific to humans; animal
• Understand botanical / natural support testing is not possible
for HR HPV and Cervical Dysplasia
This Photo by Unknown Author is licensed under CC BY-SA
• The Common Rule – patients must be informed of
and consent to research – established in 1991 in
response to this breach and subsequent legal
action.

Human Papilloma Virus (HPV)

• Non-enveloped, double stranded, circular DNA virus (Cardoza-Favarato, 2023)
• There are many (182+) types of HPV
HPV •
•
In most people, HPV is cleared by the body’s immune system
Some types are benign, and some types have the potential to stimulate cell
Human Papilloma Virus changes that can progress to cancer
• 4.5% of all cancers are due to HPV infection (Alhamlan et al, 2021)
• Cervical, anal, vulvovaginal, penile, oropharyngeal
• Cervical cancer declining due to screening and treatment; oropharyngeal
cancer increasing (Lewis, 2021)
• There is no conventional treatment for HPV (Alhamlan et al, 2021)
This Photo by Unknown Author is licensed under CC BY-NC-ND

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HPV Prevalence • Transmitted by skin-to-skin contact

• Mucosal HPV transmitted sexually
(genital-genital, genital-oral; oral-
oral rare)
• Autoinoculation (hand to hand)
• Perinatal – vaginal delivery
High risk HPV in women of Bimodal spike of HR HPV in (Wierzbicka et al, 2023)
All types (low and high risk) “all ages” women
• 40% of 15–59-year-olds in • 11% of women [26,302 • Adolescence (start of HPV Transmission • Infections are usually asymptomatic
the United States specimens] sexual activity) and and often missed
• 41.8% in men* and 38.4% • 84% had non-HPV16/18 peri/menopause (Gravitt,
in women (Miller et al, 2020) 2013)
• Unclear if this is related to
• Screening for cervical dysplasia and
• Disease-associated HPV HPV have decreased prevalence
in 24.2% of males and sexual practices, updated
19.9% in females screening, or reactivation of • No guidelines for oral or male genital
latent virus screening
• 32% of 15–24-year-olds
• 25.6% in men* and 40.1% • Anal screening guidelines just
in women (Lewis, 2021)
released

HPV Classification by Tissue Skin (Cutaneous) Warts

Type Appearance Location HPV types

Skin (cutaneous) warts / Mucosal / anogenital – most Epidermodysplasia Common Cauliflower- Fingers, 1, 2, 4, 27, 57
Non-genital common STI verruciformis
warts (verruca like papules knees, around
• HPV 1, 2, 3, 4, 10, 27, 28,
55, 57
• Low risk HPV • Rare genetic condition of
immunocompromise
vulgaris) Skin (Cutaneous) Warts
nails
• 6, 11, 43, 53, 57, 81, 84
• Anogenital warts resulting in inability to fight Plantar warts Raised,
Affectinward
~ 10% ofSoles of feet highly
the population; 1, 2, 4, 27, 57,
recurrent
HPV infection; can develop
• Juvenile and adult
into Bowen disease and (verruca growing, can (Hekmatjah et al, 2021)
60, 65
recurrent respiratory
papillomatosis
squamous cell carcinoma plantaris) contain black
• High risk HPV [cervix, dots
vagina, anus, oropharyngeal
tissue] Flat/plant Flat topped, Face, top of 1, 3, 10, 27,
• Types 16, 18, 31, 33, 35, warts (verruca skin colored, hands/feet, 57, 65
45, 51, 52, 56, 58, 59, 68
plana) raised arms, legs
(Myers, 2024)

Mucosal HPV Low Risk

Anogenital warts (condyloma acuminata)
Skin (Cutaneous) Wart Treatment • Transmitted by skin contact
• Usually due to HPV 6, 11 - don’t progress to cancer
• Ablative therapies: • Ablative and immune therapies
This Photo by Unknown Author is licensed under CC BY

• Keratolytic therapies cause skin to shed (salicylic acid, alpha-hydroxy acids, urea, and lactic acid) – do • Podophyllum peltatum (mayapple) rhizome-derived
not directly impact virus (Hekmatjah et al, 2021) medications (Kore & Anjankar, 2023)
• Cryotherapy, laser treatment, intralesional, systemic (Hekmatjah et al, 2021) • Podophyllin resin tincture (Podocon-25),
podophyllotoxin lignan - Podofilox 0.5% gel
• Botanicals: topical or oral (Condylox, Wartec)
• Hypericum perforatum (St. John’s Wort), Melissa officinalis (lemonbalm), Glycyrrhiza (licorice) (Nelson • Imiquimod, trichloroacetic acid (TCA), cryotherapy,
et al, 2017), Camellia sinensis (tea), Larrea tridentata (chaparral), Curcuma longa (turmeric), CO2laser therapy (Kore & Anjankar, 2023)
Chelidonium majus (greater celandine) latex (Nawrot et al, 2020), Argemone Mexicana (Mexican prickly • Veregen (sincatechins) ointment 15% - use outside genital
poppy) tissue only
• Topical tea tree, thuja, thyme volatile oils
This Photo by Unknown Author is licensed under CC BY-NC

• Anti-oxidative activity; growth inhibition in all four HPV-

• Homeopathy: Thuja, Natrum sulf (soft, red, fleshy), Nitric acid (cauliflower-like) infected tumor cell lines
• Banana peel, garlic juice, pineapple juice, potato, duct tape.. • Protection from transmission (condoms)
• 80% will resolve within 2 years (Hekmatjah et al, 2021) • HPV vaccine protects against types 6 and 11

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 2025 Medicines from the Earth HPV & Cervical Dysplasia - Stage

Mucosal HPV - • High risk HPV can affect the cervix, vagina,
anus, penis, and oropharyngeal tissue
• HPV has the potential to trigger cell changes and
dysplasia, but it doesn’t always do so. Cervical
High Risk • Types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56,
58, 59, 66, and 68
cancer typically takes years to develop.
• Dysplasia classified as high grade (HSIL) and low-
• Most pathogenic: 16, 18
• Typing is a new practice in conventional
HPV, Cervical grade (LSIL); not always a progression
medicine - most commonly, only 16 and
18/45 are typed
Dysplasia, and • Spontaneous clearance of the HR HPV occurs in
approximately 29% and 41% of cases at 6 and 18
• Transition zone: columnar cells replaced by Cancer months, respectively (Serrano et al, 2021)
squamous cells • Persistent HPV infection, especially with higher
• Cervical HPV and transmission is the most risk types, is most likely to be trigger dysplasia
researched • In most people, cleared within 2 years
• Assume many of the treatments effective for • Persistence > 1 year associated with increased
cervical dysplasia can also be used for HPV prevalence of progression to cervical or oral dysplasia
in other areas of the body (Wierzbicka et al, 2023)

Sheldahl, CC BY-SA 4.0, via Wikimedia Commons Hariadhi

• 9 valent [Gardasil-9] (2014)

• HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58
• 2 dose scheduled age (at first vaccination) 9-14, 3 • Limit sexual partners
dose schedule age 15-45
• In people aged 27-45, less clear benefits from
• Condoms
vaccination unless MSM, immunocompromised, • Smoking cessation
victims of sexual assault, transgender individuals
(Socca et al, 2024) • Tobacco use (current, hx with 5 pack
• SE: pain/swelling at injection site, headaches,
pyrexia, fatigue, nausea, syncope HPV years) is a risk factor for HPV infection
and dysplasia/cancer

Prevention
• Adverse effects reported: abdominal pain, • Prevalence of HPV in women who smoke
Prevention – syncope, dizziness, loss of consciousness,
alopecia, amenorrhea, anemia, dyskinesia,
is 40.8%; prevalence in women who do
not smoke is 25.2%
HPV Vaccine migraine, pallor, and seizures
• CI: hypersensitivity to yeast (vaccine expressed • Prevalence of HPV in men who smoke is
in Saccharomyces cerevisiae) or to past dose of 68.2%; prevalence in men who do not
HPV vaccine smoke is 63.2% (Zou et al, 2023)
• Not given in pregnancy (Socca et al, 2024) • Male circumcision (Shapiro et al, 2023)
• Does not protect against all high-risk HPV types
[35, 39, 51, 56, 59, 66, and 68]
This Photo by Unknown Author is licensed under CC BY-SA

Cervical Cancer Screening • Was recently (April 2025) incorporated into screening
guidelines
• Papanicolaou (pap) / Cytology - sample of cells
• Self collected vaginal HPV testing increases access;
• Younger than 21: do not screen can be collected at home on self-collected in office
• Age 21-29: pap only screen every 3 years
• High sensitivity and specificity compared to clinical
• Age 30-65*: collected samples of cervix
• Pap screen every 3 years • HPV testing is more sensitive than cytology (pap)
• Primary HPV test [FDA approved – Cobas, Onclarity] every 5
years
HPV Self • Used for asymptotic patients at average risk
• Co-testing (pap with HR HPV test) every 5 years
This Photo by Unknown Author is licensed under CC BY-NC-ND

Collection • NOT for those with abnormal bleeding or discharge,

people living with HIV, in utero DES exposure, or
• HR HPV types tested by most labs surveillance after abnormal pap / colposcopy (CIN2+) or
adenocarcinoma
• 16 and 18 or 18/45
• Other HR (not individually typed) 31, 33, 35, 39, 45, 51, 52, 56, 58, • Guidance covers FDA approved tests only [both
59, 66, 68 identify types 16, 18]
• BD Onclarity HPV Assay with the Copan 522C.80 swab –
• Swabs available [other manufacturers] for HPV testing cervix, also identifies 31, 45, 51, 52
vagina, anus, oral mucosa; can test for ALL HPV types • Roche cobas assay with the Evalyn brush or Copan
522C.80 swab (Wentzensen et al, 2025)

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 2025 Medicines from the Earth HPV & Cervical Dysplasia - Stage

HPV Typing • Types 16, 18 highest risk, most

research
• Type 16 55% of cervical cancer
• Type 18 15% of cervical cancer
• Most labs test for HR HPV strains but don’t
indicate which types • Oncoproteins E5, E6, and E7
inhibit host immune response,
• 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, & 68
• Provider can test for 16 and 18/45 or reflex to this Risk Stratification degrade p53 tumor suppression
protein, promote proliferation and
• Self collection and extended typing and HPV Type inhibit differentiation of cells
• These oncoproteins are more
likely to drive cancerous changes
when associated with a
persistent infection (Scarth et al,
2021)

Anal Cancer Screening

Population Age to start screening Normal
Men having sex with men and/or transwomen with HIV 35
Cervical
Cancer Unsatisfactory
Women with HIV 45
Men having sex with women with HIV 45 Screening: Abnormal
Men having sex with men and/or transwomen without HIV 45 Pap / Cytology • ASC-US: atypical squamous cells of
Vulvar pre-cancer (HSIL) or cancer Within 1 year of diagnosis results undetermined significance
Solid organ transplant Within 10 years of transplant • LSIL: Low-grade Squamous Intraepithelial Lesion
Cervical / vaginal / vulvar pre-cancer (HSIL) or cancer Shared decision at 45 • ASC-H: Atypical Squamous Cells, Cannot Exclude
High-Grade Squamous Intraepithelial Lesion
Perianal warts Shared decision at 45
• AGC: Atypical Glandular Cells
Persistent cervical HPV 16 (> 1 year) Shared decision at 45 • HSIL: high-grade squamous intraepithelial lesion
Autoimmune conditions/immunosuppression (RA, SLE, IBD, systemic Shared decision at 45
steroid treatments)
International Anal Neoplasia Society's consensus guidelines for anal cancer screening. Int J Cancer. Stier et al, 2024

Management – Provider or Self Collected

Management – Provider Self-Collected Vaginal Specimens for HPV Testing: Recommendations From the Enduring Consensus Cervical Cancer Screening and

Collected Management Guidelines Committee. J Low Genit Tract Dis. 2025

• Guidelines for management of abnormal

pap and/or + HPV are becoming more
complex and individualized
• Recommend ASCCP App ($10)
• More info
• These algorithms based on typing for 16
and 18/45 only

Dual stain = pap/cytology Copyright © 2025 Wolters Kluwer. Published by Lippincott Williams & Wilkins.

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 2025 Medicines from the Earth HPV & Cervical Dysplasia - Stage

Repeat testing
• Add pap if self-collected
• Add HPV testing with typing if not done
• Repeat in one year
Further Workup Colposcopy

For Abnormal • Colposcope allows for better visualization of

cervix
Pap/HPV • Ectocervical sampling (biopsy)
• Endocervical sampling (endocervical
curettage, ECC)

Endometrial biopsy
• To workup glandular cells (AGC) or after + ECC
Cervical Dysplasia
CC BY 4.0

• Must be satisfactory for evaluation

• Full lesion visible and transformation • There is no conventional treatment for HR

Colposcopy zone visible

• Normal biopsy
HPV
• Vaccine as a preventative – most effective

Results • Abnormal
• CIN 1 (LSIL)
if given in younger people
• Loop electrosurgical excision procedure
• CIN II à p16/Ki67 stain à
CIN I (downgraded)
CIN 2,3 (upgraded) Conventional (LEEP)
• Most common procedure; sometimes
• CIN III (HSIL)
• Carcinoma in situ Treatment done with colposcopy “see and treat”
• Removal of transformation zone
• Invasive cervical cancer
• Cryotherapy
• ECC positive: dysplasia in endocervical • Destruction of transformation zone;
canal – may be more limited on natural biopsy of tissue not possible
treatment, as this area is difficult to
access • Conization / cold knife cone
• Hysterectomy

This Photo by Unknown Author is licensed under CC BY

• Treat both HPV and cervical dysplasia (if

present)
• Treat nutritional deficiencies
• Build the immune system

Natural Support for HR HPV Treatment

• Educate the patient on
• Practices that reduce risk

& Cervical Dysplasia goals

• Safe sex practices - consider treating
partner(s)
• Refer appropriately
• If glandular cells are present or ECC is
positive
• Unsatisfactory colposcopy
• Invasive cancer or out of scope

This Photo by Unknown Author is licensed under CC BY-SA

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 2025 Medicines from the Earth HPV & Cervical Dysplasia - Stage

Delivery Systems
• Oral / systemic
• Great for general immune support and
addressing symptoms
• Tonics, immune modulators, antiviral,
hormone modulators
• Vaginal/cervical treatment
• More effective in my experience but also
more challenging for patients
• Avoid use during menses
• Wear liner the next day; there may be
discharge
• Often used at night

Botanical Support • Suppositories

• Vaginal gel / glycerite – used with vaginal
applicator / menstrual disc / Caya
diaphragm
Immune Support / Anti- HPV

Camellia sinensis
(green tea) Camellia sinensis (green tea)
• Catechins are potent antioxidants and
antiviral against HPV
• Epigallocatechin-3-gallate (EGCG) ECGC and polyphenol E
inhibits development of cervical cancer
in cell lines
inhibit HPV-positive
• ECGC downregulates oncoproteins E6 epithelium and cervical
and E7
• Stimulates apoptosis in cervical cancer
cancer growth in vitro at least
cells (Butler & Wu, 2011) in part by increasing p53 and
• Sincatechins inhibit growth of cervical cancer
cell lines (Tyring, 2012)
P51 protein expression,
• Used for anogenital warts / low risk HPV apoptosis, and cell cycle
types
progression (Zou et al, 2010) Int J Gynecol Cancer. 2010 May;20(4):617–624. doi: 10.1111/IGC.0b013e3181c7ca5c

• Dose: 50-200mg a day (high polyphenols);

may contain minimal caffeine
• Makes a great beverage; 1-3 cups a day
This Photo by Unknown Author is licensed under CC BY-SA-NC

Green Tea Delivery System Trametes/Coreolus versicolor

(Turkey tail mushroom)
• CIN II, 51 patients compared to 39 controls (no treatment); 8-12 weeks • Polysaccharides are immune modulating
• 20 of the 27 (74%) using ointment (Polyphenon E: ECGC and polyphenol E) 2x/week showed a with some evidence to support use in
response cervical, ovarian, prostate, colon, and lung
• 3 out of 6 (50%) using daily oral green capsules (200mg ECGC/polyE) showed a response cancers
• 6 of 8 (75%) using the ointment + oral capsules showed a response • Inhibited cervical cancer cell lines (Rokos
• 69% response in those treated with green tea, compared with 10% of controls (Ahn et al, 2003) et al, 2023)
• Another study looked at 98 women with CIN I (LSIL) and HPV • In cancer cells, can indices cell cycle
• 200mg oral Polyphenon E capsules (85–95% catechins, of which 56–72% are EGCG) daily vs
inhibition and apoptosis (Lowenthal et al,
placebo for 4 months
2023)
• High % neg HPV in treatment group, not statistically significant – but many challenges in study • Best extracted in water, most studies on
design (Garcia et al, 2014) fruiting body
• I use 150mg suppositories (compounded) • Dose: 1-3 grams a day – capsules, powder,
tea
This Photo by Unknown Author is licensed under CC BY-SA-NC

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 2025 Medicines from the Earth HPV & Cervical Dysplasia - Stage

Trametes versicolor
(turkey tail) &
Ganoderma lucidum • Coriolus versicolor (turkey tail),
(reishi) Lactobacillus crispatus, hyaluronic acid,
beta-glucan, Centella asiatica (gotu

Turkey Tail
• Oral HPV
kola), Azadirachta indica (neem) and
• 472 patients underwent oral swabs for Aloe vera extracts in vaginal gel
gingivitis and were tested for HPV

Vaginal
• Better results in patients with ASC-US
• 61 were positive for HPV16 or HPV18 in
oral cavity. and LSIL (HPV) compared to watchful
waiting
• 20 patients were given Laetiporus
sulphureus (control)
• 5% clearance after 2 months of
treatment
Treatment • HPV cleared at twice the rate of those
doing watchful waiting after 6 months
• Used once a day (vaginally) for 21 days –
• 41 patients were given Trametes stop during menses
versicolor & Ganoderma lucidum
• After that, use every other day
• 88% clearance (P<0.001) after 2
months of treatment (Donatini, 2014) • Well-tolerated (Serrano et al, 2021)
This Photo by Unknown Author is licensed under CC BY-SA

Curcuma Longa Turmeric – Delivery

(turmeric) rhizome System
• Long history of use for inflammation and immune support
• Oral 500mg-2,000mg a day in a bioavailable form
• Curcumin inhibited expression of E6/7 oncoproteins, decreased
cell invasion and migration, and supported apoptosis in • Vaginal
cervical cancer cell lines (in vitro) (Zhao et al, 2024) • Suppositories can be messy!
• Curcumin cytotoxic to cervical cancer in vitro, particularly cells • Intravaginal capsule dose escalation study for tolerability with
infected with HPV 16 or 18, compared to non-HPV infected cells Curcumin C3 complex
(Divya & Pillai 2006) • 500mg-2,000mg
• HPV positive cervical cancer cells pre-treated with estradiol • SE: vaginal discharge, pruritis, dryness
decrease apoptosis; when curcumin counteracted this effect • “84% of women (n=11/13) disliked the color of the
(Singh & Singh 2011) curcumin, and the majority found it was too messy. All the
• Increased efficacy when combined with elegiac acid study subjects agreed they would recommend this product
(pomegranate), quercetin, resveratrol, ECGC, and Paclitaxel to women as a way to prevent cervical precancerous
(Zhang et al, 2023) disease from turning into cancer, if approved as safe and
effective”. (Gattoc et al, 2017)
This Photo by Unknown Author is licensed under CC BY
This Photo by Unknown Author is licensed under CC BY-NC-ND

Glycyrrhiza – Delivery System

Glycyrrhiza glabra (licorice)
• Broad spectrum antiviral, vulnerary,
inflammation modulator, and • Standardized topical gel Glizigen (0.1% glycyrrhizinic acid)/ Epigen
adaptogen • Cervical LSIL: topical use for 10 days; lesions normalized in 80%
• Can inhibit cancers including cervical • Cervical/vag LSIL for 8-12 weeks vs imiquimod, resolved in 57% of Gly vs. 18% with imiquimod;
(in vitro) and synergistic with some Gly with less side effects (Bravo et al, 2023)
types of chemotherapy (cisplatin, 5-FU) • Topical + oral
• Reduces expression of HPV E6 and E7 • Glizigen/Viusid oral: licorice 100mg, L-arginine 2g, L-glycine, Medicago 120mg, vitamin C 60mg,
oncoproteins and restores inhibited p53 B5 50mg, B6 1.8mg, folic acid 200mcg, cyanocobalamin 0.9mcg, zinc 15mg, glucosamine
sulfate potassium chloride 2g, aspartame and orange flavor
• Cytotoxic against cervical cancer cells • Cervical LSIL for 12 weeks; negative cytology in 74%
• HPV+ women & partner treated**; 88.8% negative at 4 weeks, 100% negative at 8 weeks; 14%
recurrence in 6 months – in all cases, partner not treated or new partner (Bravo et al, 2023)
• Dose: 100-400mg a day
• Vaginal suppository, gel/glycerite

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 2025 Medicines from the Earth HPV & Cervical Dysplasia - Stage

Sarracenia purpurea Other Herbs of Interest

(pitcher plant) • Punica granatum (pomegranate) peel *
• Astragalus membrinaceus *
• Historically used to treat smallpox • Lomatium dissectum (desert parsley)
(Garcia, 2020)
• Hypericum perforatum (St.John’s wort)
• Treatment of cervical cells with • Melissa officinalis (lemon balm)
Sarracenia inhibited HPV E6/E7,
• Thuja occidentalis / plicata (Eastern white cedar /red cedar) *
increased expression of p53, and
indicated cancer cell death • Mahonia aquifolium (Oregon grape)/ berberine containing
herbs*
(Moore and Langland, 2018)
• Larrea tridentata (chaparral) *
• Thymus vulgaris (thyme) *
• Sanguinaria canadensis (blood root) *
• Chelidonium majus (greater celandine) *
* Indicates at least one study in which the
• Laurus nobilis (bay leaf) * herb shows some effect on HR HPV or
cervical cancer
This Photo by Unknown Author is licensed under CC BY-SA-NC

Sex partners of Women with

• Regular exercise HPV/Dysplasia
• Lack of regular physical activity associated

Whole
• Study looked at 90 male partners of women
with increased odds of cervical cancer with HR HPV/dysplasia
(Szender et al, 2016) • 66.7% also tested for HPV; only 5.6% had
• Smoking Cessation symptoms (condylomatous lesions)

Person
• Most common HR HPV 31, 52, 53, 42, 51,
• Smoke impacts DNA methylation, exposes 66 (only 31 and 52 in vaccine) (Sucato et
one to a number of toxins, upregulates al, 2025)
inflammatory cytokines, may delay clearance • Unfortunately – no data on same sex partners

Support
of HPV (Fonseca-Moutinho, 2011) for this question
• Avoid wood burning fires (Fonseca-Moutinho, • HPV is associated with penile squamous cell
carcinomas but limited conservative
2011) treatment [surgery, chemo/radiation (and
vaccination)]
• Nutrient dense diet, rich in antioxidants
• Will oral support of sex partner help the
• Use of condoms, or pelvic rest patient with HR HPV/cervical dysplasia?

Nutrition • Folic acid promotes DNA methylation, which can

influence cancer cell transformation
• Zinc (30mg)

Folic Acid
• Lower intake associated with higher rates of cervical cancer • Lower levels of folate and higher homocysteine
(Ferrari et al, 2023) correlate with higher risk of cervical dysplasia, HPV
• Intravaginal zinc citrate 0.5mM 2x/week for 3 months showed persistence, and risk of cervical cancer
higher rate of HPV regression 49/76 (64.47%) compared to no
treatment (18/118) 15.25% (Kim et al, 2021)
• Selenium (100-200mcg)
• Mixed evidence, supplementation associated with
and • Women with higher plasma concentrations of folate (≥
14.29 ng/mL) and a higher degree of HPV 16 (≥ 11%)
were 75% less likely to be diagnosed with CIN 2+,
higher CIN1 regression rate (Ferrari et al, 2023)
• Vitamin C (500-3,000mg) Vitamin suggesting that such folate levels may allow them to
keep the expression of E6 at a lower level (Piyathilake et
al, 2013).

B12
• Lower risk of HPV and cervical cancer associated with
higher serum levels (Ferrari et al, 2023) • 5mg a day of folate for 6 months showed higher
regression rate in women with CIN I compared to
• Vitamin E (400IU) placebo (Ferrari et al, 2023)
• Higher intake/higher serum levels may protect against
cervical dysplasia and cancer • Dose: at least 475mcg DFE (I typically prefer
methylated) (Lin et al, 2021) and 1,000mcg methylB12
• Vitamin B2 (riboflavin) 2mg (Lin et al, 2021)

• .
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 2025 Medicines from the Earth HPV & Cervical Dysplasia - Stage

Carotenoids • Low dietary intake associated with higher risk of

invasive cervical cancer (Ferrari et al, 2023)
• Fat soluble nutrients, antioxidant
and immune supportive • 50,000IU oral once every 2 weeks in women with CIN I
compared to placebo for 6 months
• Lower dietary intake associated with
persistent HPV infection; higher • Higher rates of regression in vitamin D group
dietary intake associated with lower (Ferrari et al, 2023)
rates of HPV, cervical dysplasia, and • Vitamin D vaginal suppository (12,500 IU) for 3 nights a
cervical cancer (Ferrari et al, 2023) week for 6 weeks in women with CIN I or CIN II &
• High levels of retinol/vitamin A Vitamin D vaginitis, compared with Lactobacillus suppository
associated with lower rates of
• Vitamin D more effective at treating vaginitis
cervical cancer and dysplasia
symptoms
• Dose: 700mcg RAE or 2,333 IU Vit A • Reversion of CIN I but not CIN II in vitamin D group
• Excess intake associated with (Schulte-Uebbing et al, 2014)
increased risk (Lin et al, 2021)
• Dose 2,000-5,000 IU a day – titrate according to serum
• Vitamin A suppositories: 240,000 IU
(short term use)
levels

This Photo by Unknown Author is licensed under CC BY

Estrogen Modulators
• Estrogen, in particular ERα, supports proliferation of cervical
cells • Intravaginal DIM in women with CIN 1 or CIN II
(78 participants)
• Cell lines exposed to estradiol develop more frequent
breaks in DNA in high risk, HPV-E6 cells (Ogawa et al, 2023) • DIM 100mg 2x/day, DIM 100mg once a day,
• Indole 3 carbinol (I3C) and metabolites diindolylmethane
(DIM) support estrogen metabolism Intravaginal placebo suppository 2x/day for 180 days (at 90
days, if CIN was normal, treatment was
stopped)

DIM
• DIM disrupts HPV proliferation and inhibits E6/E7 in • DIM 200mg 2x/day: 19/19 reverted (100%)
cervical cell cultures
• DIM 100mg once a day: 19/21 reverted
• DIM (1,000mg a day equivalent) suppressed E6/E7 (90%)
expression in mice (Sepkovic et al, 2010)
• Placebo 2x/day: 11/18 reverted (61%)
• UK study showed 150mg oral DIM no better than
placebo for CIN2 (Castañon et al, 2012) • DIM suppository was well tolerated
• No mention of HPV testing (Ashrafian et al,
• Dose: DIM 200-400mg a day, I3C 100-200mg a day 2015)
• Consider in particular, if symptoms of estrogen
dominance

Support Healthy Vaginal Microbiome

Other Support • Vaginal hyaluronic acid (HA) supports healthy vaginal
tissue
• N-acetyl cysteine (NAC) • Supports “spontaneous” clearance of HPV and LSIL
• Reduces cell growth in cervical cancer (Laganà et al, 2023)
lines, inhibits HPV E7, and surpasses • Lactobacillus crispatus
tumor growth (Guo and Jing 2023) • Intravaginal capsule with Lactobacillus crispatus (1 × 109
• Dose: 600mg 2-3x a day CFU) in women HR HPV (those with dysplasia excluded
from study) compared with placebo
• Used for 14 days continuously months 1-3, then every 3
• Arctium lappa (burdock) root
days for months 4-5, and 5x/month in month 6.
• Taraxacum officinale (dandelion) root • HPV clearance rate 57.78% with Lactobacillus and
• Galium aparine (cleavers) areal 45.65% in placebo; improvement in inflammatory
markers more pronounced in Lactobacillus group (Liu et
• Trifolium pratense (red clover) flower al)
• BV and other vaginitis associated with higher rates of
cervical dysplasia (Gillet et al, 2012)

This Photo by Unknown Author is licensed under CC BY-SA-NC This Photo by Unknown Author is licensed under CC BY-NC-ND

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2025 Medicines from the Earth HPV & Cervical Dysplasia - Stage

Vaginal Hyaluronic Acid & Oral Echinacea root

• 153 women with HPV and LSIL/CIN I,
interventions used once a day for 10 days each
Vaginal SAM gel
month for 3-months; re-pap at 3, 6, & 12 months
• Oral Echinacea ang/purpurea root extracts • 10.0mg silicon dioxide + Deflamin (24.8mg of citric acid, 0.25mg of
(100mg EA/100mg EP, 4 mg polyphenols, vitamin selenium)
C 40 mg, zinc 5mg, copper 0.5 mg with vaginal • Self administered daily for 3 months in women with CIN II or CIN I
HA gel capsules +p16/Ki67 - compared with “watch and wait” for 3 months, 6 months
• At 6 and 12 months, highest levels of regression – • Investigated HPV, p16/Ki-67, and cytology
12 months: 46/51 (92%) • 77% gel users reverted to cytology negative (77%); 32 (49%) reverted to
• Echinacea supplement alone HPV negative and no new infections
• Regression a 12 months - 32/38 (84%) • 21% placebo reverted to negative (22%); 8/76 cleared HPV but 13/76
were newly infected (Major et al, 2021)
This Photo by Unknown Author is licensed under CC BY
• Vaginal hyaluronic acid alone
• Regression a 12 months - 34/48 (71%)
(Riemma et al, 2022)

Other Vaginal Support Sample Diet Approach

• Test for and treat vaginitis – can cause low • Avoid inflammatory foods: fried foods, trans
grade dysplasia and undue stress fats, and conventional red meat. Meat should
• Oral probiotics (women’s) and vaginal be organic/grass fed and finished.
probiotics
• 1 tablespoon of fresh ground flax seeds a
• Can test vaginal microbiome day.
• L. Crispatus (LG55-27), L. gasseri
(TM13-16), L. jensenii most beneficial • Increase vegetables from the brassica family:
(Lyu et al, 2024) broccoli, cauliflower, kale, Brussels sprouts,
• Want low levels of L. iners
and cabbage.

• Other considerations
• Increase intake of fermented foods:
sauerkraut, pickles, miso/tempeh, yogurt,
• Vaginal estriol kefir.
• Vitamin E suppositories
• Aim for ½ body weight of water a day.
• Vaginal moisturizers This Photo by Unknown Author is licensed under CC BY

• Calendula officinalis flower oral or • Reduce coffee in favor of green tea.

suppositories • Eat organic when possible.

Increase foods rich in

• Folic acid: beans, lentils, spinach, asparagus, Sample Lifestyle Plan
lettuce, avocado, broccoli, mango, oranges
• Vitamin B12: shellfish, liver, fish, crab, beef, dairy,
eggs • Regular exercise (30 minutes at least 3-4
times a week)
• Ascorbic acid: bell peppers, guava, dark green
leafies, kiwi, strawberries, broccoli, citrus, • Stress management support
tomatoes, pea, papaya • Smoking cessation support if needed
• Carotenoids/Vit A: sweet potato, carrots, dark • Use condoms with intercourse
green leafies, lettuce, butternut squash,
• Avoid hormone disrupting chemicals
This Photo by Unknown Author is licensed under CC BY
cantaloupe, dried apricots, broccoli, peas
• Riboflavin: almonds, cheese, beef, lamb, oily fish,
mackerel, pork, egg, mushrooms, sesame seeds, • Consider treating partner(s), especially in
squid, spinach resistant / recurrent infections.
• Selenium: Brazil nuts, seafood, poultry, eggs,
whole grains, lentils

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 2025 Medicines from the Earth HPV & Cervical Dysplasia - Stage

• Consider severity of presentation, lifestyle

Natural Support (daily) factors, ability and interest
• Likely to be more effective than oral, or best
effects if combined
• Methylated folic acid 1,000mcg DFE
• Consider break days
• Methylated Vitamin B12
• Green tea polyphenols
1,000mcg
1-3 cups/50-200mg
Vaginal Support • Assess for vaginal irritation
• Do not instruct patient to insert capsules
• Trametes versicolor 1-3 grams, divided Considerations •
meant for oral use into vagina!
Green tea suppositories
• Vitamin C + bioflavonoids 500mg-6g, divided
• NAC 1200-1800mg, divided • Vitamin A suppositories
• DIM 200-400mg • Trametes versicolor vaginal gel
• Other herbs as supps, glycerites/gels
• Vaginal probiotics, hyaluronic acid, vit E,
3-12+ months Calendula

Escharotic Procedure
• Used for dysplasia when the patient refuses
conventional treatment
• If satisfactory colposcopy, no endocervical More Info
dysplasia, and no contraindications to the
procedure
• Limited research
• Treatment guidelines in Women’s Encyclopedia
• Performed in office; twice a week for 10 sessions of Natural Medicine
(not done during menses)
• The Beautiful Cervix Project
• Ingredients: bromelain, zinc chloride/Sanguinaria
https://www.beautifulcervix.com/
canadensis root, Calendula succus; green tea
supposititious after treatment
• May be combined with oral treatment; typically
This Photo by Unknown Author is licensed under CC BY
followed by a round of vaginal suppositories
• More info case study & case study update

References
• Ahn WS, Yoo J, Huh SW, et al. Protective effects of green tea extracts (polyphenon E and
EGCG) on human cervical lesions. Eur J Cancer Prev. 2003;12(5):383-390.
doi:10.1097/00008469-200310000-00007

Thanks for • Alhamlan FS, Alfageeh MB, Al Mushait MA, Al-Badawi IA, Al-Ahdal MN. Human
Papillomavirus-Associated Cancers. Adv Exp Med Biol. 2021;1313:1-14. doi:10.1007/978-3-
030-67452-6_1
listening! • Ashrafian L, Sukhikh G, Kiselev V, et al. Double-blind randomized placebo-controlled
multicenter clinical trial (phase IIa) on diindolylmethane's efficacy and safety in the
treatment of CIN: implications for cervical cancer prevention. EPMA J. 2015;6:25. Published
katiestage@gmail.com 2015 Dec 21. doi:10.1186/s13167-015-0048-9
• Bravo V, Serrano M, Duque A, Ferragud J, Coronado PJ. Glycyrrhizinic Acid as an Antiviral and
Anticancer Agent in the Treatment of Human Papillomavirus. J Pers Med. 2023;13(12):1639.
Published 2023 Nov 24. doi:10.3390/jpm13121639

254
 2025 Medicines from the Earth HPV & Cervical Dysplasia - Stage

References References
• Butler LM, Wu AH. Green and black tea in relation to gynecologic cancers. Mol Nutr Food • Ferrari FA, Magni F, Bosco M, et al. The Role of Micronutrients in Human Papillomavirus
Res. 2011;55(6):931-940. doi:10.1002/mnfr.201100058 Infection, Cervical Dysplasia, and Neoplasm. Healthcare (Basel). 2023;11(11):1652.
• Castañon A, Tristram A, Mesher D, et al. Effect of diindolylmethane supplementation on low- Published 2023 Jun 5. doi:10.3390/healthcare11111652
grade cervical cytological abnormalities: double-blind, randomised, controlled trial. Br J • Fonseca-Moutinho JA. Smoking and cervical cancer. ISRN Obstet Gynecol.
Cancer. 2012;106(1):45-52. doi:10.1038/bjc.2011.496 2011;2011:847684. doi:10.5402/2011/847684
• Divya CS, Pillai MR. Antitumor action of curcumin in human papillomavirus associated cells • Garcia FA, Cornelison T, Nuño T, et al. Results of a phase II randomized, double-blind,
involves downregulation of viral oncogenes, prevention of NFkB and AP-1 translocation, and placebo-controlled trial of Polyphenon E in women with persistent high-risk HPV infection
modulation of apoptosis. Mol Carcinog. 2006;45(5):320-332. doi:10.1002/mc.20170 and low-grade cervical intraepithelial neoplasia. Gynecol Oncol. 2014;132(2):377-382.
• Donatini B. Control of oral human papillomavirus (HPV) by medicinal mushrooms, Trametes doi:10.1016/j.ygyno.2013.12.034
versicolor and Ganoderma lucidum: a preliminary clinical trial. Int J Med Mushrooms. • Garcia S. Pandemics and Traditional Plant-Based Remedies. A Historical-Botanical Review in
2014;16(5):497-498. doi:10.1615/intjmedmushrooms.v16.i5.80 the Era of COVID19. Front Plant Sci. 2020;11:571042. Published 2020 Aug 28.
doi:10.3389/fpls.2020.571042

References References
• Gattoc L, Frew PM, Thomas SN, et al. Phase I dose-escalation trial of intravaginal • Hekmatjah J, Farshchian M, Grant-Kels JM, Mehregan D. The status of treatment for plantar
curcumin in women for cervical dysplasia. Open Access J Clin Trials. 2017;9:1-10. warts in 2021: No definitive advancements in decades for a common dermatology disease.
doi:10.2147/OAJCT.S105010 Clin Dermatol. 2021;39(4):688-694. doi:10.1016/j.clindermatol.2021.05.024
• Gillet E, Meys JF, Verstraelen H, et al. Association between bacterial vaginosis and • Kim JH, Bae SN, Lee CW, et al. A pilot study to investigate the treatment of cervical human
cervical intraepithelial neoplasia: systematic review and meta-analysis. PLoS One. papillomavirus infection with zinc-citrate compound (CIZAR®). Gynecol Oncol.
2012;7(10):e45201. doi:10.1371/journal.pone.0045201 2011;122(2):303-306. doi:10.1016/j.ygyno.2011.04.026
• Gravitt PE, Rositch AF, Silver MI, et al. A cohort effect of the sexual revolution may be • Kore VB, Anjankar A. A Comprehensive Review of Treatment Approaches for Cutaneous and
masking an increase in human papillomavirus detection at menopause in the United Genital Warts. Cureus. 2023;15(10):e47685. Published 2023 Oct 25.
States. J Infect Dis. 2013;207(2):272-280. doi:10.1093/infdis/jis660 doi:10.7759/cureus.47685
• Guo W, Jing W. N-Acetyl-L-Cysteine Reduces Cervical Carcinogenesis by Promoting • Laganà AS, Chiantera V, Gerli S, et al. Preventing Persistence of HPV Infection with Natural
Apoptosis. Drugs R D. 2023;23(2):165-174. doi:10.1007/s40268-023-00423-9 Molecules. Pathogens. 2023;12(3):416. Published 2023 Mar 6.
doi:10.3390/pathogens12030416

References References
• Lewis RM, Laprise JF, Gargano JW, et al. Estimated Prevalence and Incidence of Disease- • Luria L, Cardoza-Favarato G. Human Papillomavirus. In: StatPearls. Treasure Island (FL): StatPearls
Associated Human Papillomavirus Types Among 15- to 59-Year-Olds in the United States. Publishing; January 16, 2023.
Sex Transm Dis. 2021;48(4):273-277. doi:10.1097/OLQ.0000000000001356 • Lyu J, Gao M, Zhao S, et al. From whole genomes to probiotic candidates: A study of potential
• Lin HY, Fu Q, Kao YH, et al. Antioxidants Associated With Oncogenic Human Papillomavirus lactobacilli strains selection for vaginitis treatment. Heliyon. 2024;10(9):e30495. Published 2024 Apr
30. doi:10.1016/j.heliyon.2024.e30495
Infection in Women. J Infect Dis. 2021;224(9):1520-1528. doi:10.1093/infdis/jiab148
• Major AL, Skřivánek A, Grandjean EM, et al. An Adsorptive and Antioxidant Vaginal Gel Clears High-Risk
• Liu Y, Zhao X, Wu F, et al. Effectiveness of vaginal probiotics Lactobacillus crispatus chen-01 HPV- and p16/Ki-67-Associated Abnormal Cytological Cervical Findings: A post-hoc Subgroup Analysis
in women with high-risk HPV infection: a prospective controlled pilot study. Aging (Albany of a Prospective Randomized Controlled Trial on CIN2 and p16 Positive CIN1. Front Med (Lausanne).
NY). 2024;16(14):11446-11459. doi:10.18632/aging.206032 2021;8:645559. Published 2021 May 25. doi:10.3389/fmed.2021.645559
• Lowenthal R, Taylor M, Gidden JA, et al. The mycelium of the Trametes versicolor synn. • Miller D, Morris CP, Maleki Z, White M, Rodriguez EF. Health disparities in cervical cancer: Prevalence of
Coriolus versicolor (Turkey tail mushroom) exhibit anti-melanoma activity in vitro. Biomed high-risk HPV and cytologic diagnoses according to race. Cancer Cytopathol. 2020;128(11):860-869.
Pharmacother. 2023;161:114424. doi:10.1016/j.biopha.2023.114424 doi:10.1002/cncy.22316

255
 2025 Medicines from the Earth HPV & Cervical Dysplasia - Stage

References References
• Moore M, Langland JO. Sarracenia purperea: A Botanical Extract With Anti-papilloma • Nawrot J, Wilk-Jędrusik M, Nawrot S, et al. Milky Sap of Greater
Virus and Oncolytic Activity. Integr Med (Encinitas). 2018 Apr;17(2):58–61. Celandine (Chelidonium majus L.) and Anti-Viral Properties. Int J
• Ogawa M, Hashimoto K, Kitano S, et al. Estrogen induces genomic instability in high- Environ Res Public Health. 2020;17(5):1540. Published 2020 Feb 27.
risk HPV-infected cervix and promotes the carcinogenesis of cervical doi:10.3390/ijerph17051540
adenocarcinoma. Biochem Biophys Res Commun. 2023;659:80-90.
doi:10.1016/j.bbrc.2023.04.009 • Nelson EO, Kozin AF, Ruiz G, Lasku A, Langland JO. Treatment of
• Musidlak O, Warowicka A, Broniarczyk J, Adamczyk D, Goździcka-Józefiak A, Nawrot Athlete's Plantar Warts Using a Botanical Blend: A Case Report. Altern
R. The Activity of Chelidonium majus L. Latex and Its Components on HPV Reveal Ther Health Med. 2017;23(3):51-54.
Insights into the Antiviral Molecular Mechanism. Int J Mol Sci. 2022;23(16):9241. • Piyathilake CJ, Macaluso M, Chambers MM, et al. Folate and vitamin
Published 2022 Aug 17. doi:10.3390/ijms23169241
B12 may play a critical role in lowering the HPV 16 methylation-
• Myers DJ, Kwan E, Fillman EP. Epidermodysplasia Verruciformis. In: StatPearls. associated risk of developing higher grades of CIN. Cancer Prev Res
Treasure Island (FL): StatPearls Publishing; July 20, 2024.
(Phila). 2014;7(11):1128-1137. doi:10.1158/1940-6207.CAPR-14-0143

References References
• Riemma G, Schettino MT, Munno GM, et al. Echinacea angustifolia and Echinacea purpurea • Serrano L, López AC, González SP, et al. Efficacy of a Coriolus versicolor-Based Vaginal Gel in
Supplementation Combined with Vaginal Hyaluronic Acid to Boost the Remission of Cervical Low-Grade Women With Human Papillomavirus-Dependent Cervical Lesions: The PALOMA Study. J Low
Squamous Intraepithelial Lesions (L-SILs): A Randomized Controlled Trial. Medicina (Kaunas). Genit Tract Dis. 2021;25(2):130-136. doi:10.1097/LGT.0000000000000596
2022;58(5):646. Published 2022 May 9. doi:10.3390/medicina58050646
• Shapiro SB, Laurie C, El-Zein M, Franco EL. Association between male circumcision and
• Rokos T, Pribulova T, Kozubik E, Biringer K, Holubekova V, Kudela E. Exploring the Bioactive Mycocompounds
(Fungal Compounds) of Selected Medicinal Mushrooms and Their Potentials against HPV Infection and
human papillomavirus infection in males and females: a systematic review, meta-analysis,
Associated Cancer in Humans. Life (Basel). 2023;13(1):244. Published 2023 Jan 16. and meta-regression. Clin Microbiol Infect. 2023;29(8):968-978.
doi:10.3390/life13010244 doi:10.1016/j.cmi.2023.03.028
• Scarth JA, Patterson MR, Morgan EL, Macdonald A. The human papillomavirus oncoproteins: a review of the • Schulte-Uebbing C, Schlett S, Craiut I, Antal L, Olah H. Chronical cervical infections and
host pathways targeted on the road to transformation. J Gen Virol. 2021;102(3):001540. dysplasia (CIN I, CIN II): Vaginal vitamin D (high dose) treatment: A new effective method?.
doi:10.1099/jgv.0.001540 Dermatoendocrinol. 2014;6(1):e27791. doi:10.4161/derm.27791
• Sepkovic DW, Stein J, Carlisle AD, Ksieski HB, Auborn K, Bradlow HL. Diindolylmethane inhibits cervical • Singh M, Singh N. Curcumin counteracts the proliferative effect of estradiol and induces
dysplasia, alters estrogen metabolism, and enhances immune response in the K14-HPV16 transgenic apoptosis in cervical cancer cells. Mol Cell Biochem. 2011;347(1-2):1-11.
mouse model [published correction appears in Cancer Epidemiol Biomarkers Prev. 2010 Feb;19(2):628]. doi:10.1007/s11010-010-0606-3
Cancer Epidemiol Biomarkers Prev. 2009;18(11):2957-2964. doi:10.1158/1055-9965.EPI-09-0698

References References
• Singh A, Choudhary R, Ganguly S. Podophyllin in Dermatology: Revisiting a • Szender JB, Cannioto R, Gulati NR, et al. Impact of Physical Inactivity on Risk of Developing
Historical Drug. Indian Dermatol Online J. 2022;13(1):167-171. Published 2022 Jan Cancer of the Uterine Cervix: A Case-Control Study. J Low Genit Tract Dis. 2016;20(3):230-
24. doi:10.4103/idoj.idoj_225_21 233. doi:10.1097/LGT.0000000000000210
• Soca Gallego L, Dominguez A, Parmar M. Human Papilloma Virus Vaccine. In: • Tyring SK. Effect of Sinecatechins on HPV-Activated Cell Growth and Induction of Apoptosis.
StatPearls. Treasure Island (FL): StatPearls Publishing; February 19, 2024. J Clin Aesthet Dermatol. 2012;5(2):34-41.
• Stier EA, Clarke MA, Deshmukh AA, et al. International Anal Neoplasia Society's • Wierzbicka M, San Giorgi MRM, Dikkers FG. Transmission and clearance of human
consensus guidelines for anal cancer screening. Int J Cancer. 2024;154(10):1694- papillomavirus infection in the oral cavity and its role in oropharyngeal carcinoma - A review.
1702. doi:10.1002/ijc.34850 Rev Med Virol. 2023;33(1):e2337. doi:10.1002/rmv.2337
• Sucato A, Serra N, Buttà M, Gregorio LD, Pistoia D, Capra G. Human Papillomavirus • Wentzensen N, Massad LS, Clarke MA, et al. Self-Collected Vaginal Specimens for HPV
Infection in Partners of Women Attending Cervical Cancer Screening: A Pilot Study Testing: Recommendations From the Enduring Consensus Cervical Cancer Screening and
on Prevalence, Distribution, and Potential Use of Vaccines. Vaccines (Basel). Management Guidelines Committee. J Low Genit Tract Dis. 2025;29(2):144-152.
2025;13(2):172. Published 2025 Feb 11. doi:10.3390/vaccines13020172 doi:10.1097/LGT.0000000000000885

256
 2025 Medicines from the Earth HPV & Cervical Dysplasia - Stage

References
• Zhao X, Zhang R, Song Z, et al. Curcumin suppressed the proliferation and apoptosis
of HPV-positive cervical cancer cells by directly targeting the E6 protein. Phytother
Res. 2024;38(10):4967-4981. doi:10.1002/ptr.7868
• Zhang X, Zhu L, Wang X, Zhang H, Wang L, Xia L. Basic research on curcumin in
cervical cancer: Progress and perspectives. Biomed Pharmacother.
2023;162:114590. doi:10.1016/j.biopha.2023.114590
• Zou C, Liu H, Feugang JM, Hao Z, Chow HH, Garcia F. Green tea compound in
chemoprevention of cervical cancer. Int J Gynecol Cancer. 2010;20(4):617-624.
doi:10.1111/IGC.0b013e3181c7ca5c
• Zou K, Huang Y, Li Z. Prevention and treatment of human papillomavirus in men
benefits both men and women. Front Cell Infect Microbiol. 2022;12:1077651.
Published 2022 Nov 24. doi:10.3389/fcimb.2022.1077651

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 2025 Medicines from the Earth Stage - Intestinal Permeability

INTESTINAL PERMEABILITY:
SYMPTOMS,
CONTROVERSY, AND
TREATMENT APPROACHES

Katie Stage, ND RH (AHG), FABNG

Medicines from the Earth Symposium 2025
NONE

OBJECTIVES
• “Unmediated passage through intestinal
epithelium…. that may allow entry of harmful
• Understand meaning and historical context of intestinal
INTESTINAL microorganisms, toxins, or undigested food
particles through the junctions of the intestinal
permeability PERMEABILITY epithelium, reaching the bloodstream and
• Review common symptoms and associated conditions being able to affect the hormonal, immune,
• Understand approaches to testing nervous, respiratory or reproductive systems”
• Review why this concept can be controversial
“LEAKY GUT” (Aleman et al, 2023)
• Compromised barriers in GI mucosa allow
• Understand botanical, dietary, and natural approaches to
passage of items into circulation, which can
treatment
trigger local and systemic symptoms

“GUT” MEANS AREAS OF ANOTHER PERSPECTIVE

ABSORPTION & ASSIMILATION
[BUT ALSO... SUPPORT ORGANS]

This Photo by Unknown Author is licensed under CC BY-NC

This Photo by Unknown Author is licensed under CC BY-SA

Buckley A, Turner JR. Cell Biology of Tight Junction Barrier Regulation and Mucosal Disease. Cold Spring Harb Perspect Biol. 2018;10(1):a029314.
Published 2018 Jan 2. doi:10.1101/cshperspect.a029314

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MUCOSAL EPITHELIUM
• Single layer of epithelial cells, highly
folded to increase surface area

WHAT GOES INTO THE DIGESTIVE (Ogobuiro et al, 2023)

• The largest interface with the external

SYSTEM …. CAN BE A LOT environment

• Must be able to permit absorption of
nutrients and water
How do we filter the good from the bad? • Must also limit access to toxins and
antigens (Ahmad bet al, 2017)
• Function is supported by immune
cels, mucous, bacteria/commensal
microbiota
Mucosal Immunology (2017) 10, 307-317;
doi:10.1038/mi.2016.128

COMPOSITION AND ANATOMICAL STRUCTURE OF GUT BARRIER – MICROBIOTA

THE GUT BARRIER
Epithelium protected by microbiota, chemical barriers, mucous layer, immune cells • Microbiota vary at different areas of the
GI system – influenced by pH, bile,
oxygen availability, nutrients/substrate,
and host immune cells/function
• Not just a barrier, but do support a
barrier function
• Metabolites include short chain fatty
acids, vitamin K and folate, and
signaling molecules
• Modulates immune function, endocrine
balance, and whole-body homeostasis
• 60% of fecal mass is due to microbiota
(Farré et al, 2023, de Vos et al,2022 )
Aleman RS, Moncada M, Aryana KJ. Leaky Gut and the Ingredients That Help Treat It: A Review. Molecules. 2023;28(2):619. Published 2023
Jan 7. doi:10.3390/molecules28020619 de Vos WM, Tilg H, Van Hul M, Cani PD. Gut microbiome and health: mechanistic
insights. Gut. 2022;71(5):1020-1032. doi:10.1136/gutjnl-2021-326789

MUCOSAL EPITHELIUM
GUT BARRIER – MUCOUS LAYER TRANSPORT
• Mucins secreted by goblet cells
• Allows passage of small
materials but prevents large
bacteria from passing to the
epithelium • Epithelial cells can move
• Protects epithelium from acid, substances though the cells or
bile, and other potentially between them (Ahmad et al,
damaging substance (Farré et
al, 2023) 2017)
• Supports proper immune • Paracellular transport regulated
function
by tight junction complex
• Mice without the mucus layer (Buckley & Turner, 2018)
developed spontaneous colitis
(Park et al, 2021)
• Decreased goblet cells in those
Farré R, Fiorani M, Abdu Rahiman S, Matteoli G. Intestinal Permeability, Inflammation and the with UC (Park et al, 2021)
Role of Nutrients. Nutrients. 2020;12(4):1185. Published 2020 Apr 23. doi:10.3390/nu12041185 Mucosal Immunology (2017) 10, 307-317;
doi:10.1038/mi.2016.128

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MUICOSA: LAMINA
EPITHELIAL JUNCTIONS
PROPRIA
• Apical junction complex
• Tight junctions • Layer of connective tissue
• Zonula occludins (ZO) stitch cells beneath the epithelial cells
together to prevent passage • Contains innate and
• Adherent junctions (zonula adherens) adaptive immune cells
• Cadherins connect to actin which can remove waste
filaments of neighboring cells products, toxins, pathogens
• Desmosome (macula adherens) • Low Paneth cells seen in
• Anchor / support for mechanical people with IBD (Park et al,
stress (Buckley & Turner, 2018) 2021)
• In susceptible people,
• Gap junctions gluten causes a reaction
• Connexins / protein channels that that increases release of
allow communication between cells zonulin, which causes the
(Aleman et al, 2023) tight junction to disassemble
(Park et al, 2021)
This Photo by Unknown Author is licensed under CC BY-NC

Aleman RS, Moncada M, Aryana KJ. Leaky Gut and the Ingredients That
Help Treat It: A Review. Molecules. 2023;28(2):619. Published 2023 Jan 7.
doi:10.3390/molecules28020619

Altered

CAUSES OF GI PERMEABILITY microbiome HISTORICAL CONTEXT

• Pathogens (food poisoning, parasites)

Inflammation • Ayurvedic medicine: ama (undigested/unripe)
• Diet: lacking nutrients, inflammatory & immune
response • When not adequately removed, ama accumulate, clogs
• Toxins or irritants - chemo, iron, alcohol, NSAIDs channels, and disturbs normal body processes à fatigue,
indigestion, stagnation, altered taste, heartburn, diarrhea,
• Frequent antibiotic use without microbiota support loss of sexual vitality, mental confusion (Pandey et al, 2023)
• Immune reaction (Celiac, allergies/atopy) • Amaya: disease or “that which is born out of ama”
• Acute or chronic stress Damage • Chinese medicine: disruption of spleen/stomach which can
due to toxins generate damp/stagnation (Park et al, 2021)
• Genetic susceptibility (Park et al, 2021) or irritants
• Naturopathic Medicine:
• Poor digestion damages the body’s terrain which creates an
Nutrient environment where disease can flourish
Stress deficiency &
poor repair • Maldigestion causes an accumulation of normally excreted
substances (toxemia) (Newman Turner et al, 2025)
This Photo by Unknown Author is licensed under CC BY-SA

SYMPTOMS OF INTESTINAL
PERMEABILITY

• Gas, bloating, abdominal distention

• Indigestion
• Diarrhea or constipation
• Sensitivity to many foods, “reactive”
• Fatigue, exercise intolerance
• Nutrient deficiency without other cause
• Pain
• Forgetfulness, brain fog
• Rashes

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ASSOCIATED CONDITIONS Rashes,

Allergies Acne Autism Asthma Migraines CVD / CHF
eczema
AND SEQUALAE
Type I Alzheimer’s Autoimmune Type II MAFLD /
Obesity Cancer
Diabetes dementia conditions Diabetes fatty liver
• Inflammatory bowel disease (IBD): Crohn's
disease and ulcerative colitis
• Disrupted tight junctions (Aleman et al, H. pylori Chronic
Psoriasis
IBD, Celiac
Fibromyalgia SIBO / IMO Dysbiosis
2023) infection fatigue disease

• Irritable bowel syndrome (IBS)

• Have less zonula occludin protein
(Aleman et al, 2023)
• Celiac disease
• Reaction to gluten triggers inflammatory
ASSOCIATED CONDITIONS AND SEQUALAE
response and alters tight junction
function (Aleman et al, 2023) This Photo by Unknown Author is licensed under CC BY-SA

(Aleman et al, 2023)

Tests run will depend on

Most tests are indirect symptoms, finances,
markers collection ability, &
accessibility

Results indicating Testing can be helpful.

permeability/“leaky gut” Many treatments are safe
do not necessarily provide to start based on clinical
treatment direction suspicion

TESTING CONSIDERATIONS

URINE TESTS
BREATH TEST FOR SIBO / IMO

• Small Intestinal Bacterial Overgrowth & Intestinal Methanogen Overgrowth

(IMO)
• Excessive hydrogen (H2) or hydrogen sulfide (H2S) bacteria in small intestine
Lactulose-mannitol test Organic acids test (OAT) / • Excessive methane (CH4) in small or large intestine
Microbial organic acid test (MOAT) • Most common symptoms: diarrhea/ constipation, bloating/gas/distention,
Lactulose is not absorbed but mannitol is; both Metabolites suggest yeast and bacterial heartburn, abdominal pain, malabsorption, many food sensitivities
solutions are ingested, and levels are overgrowth, nutrient absorption, toxin
measured in urine. High lactulose – more exposure, methylation status, and antioxidants • Must be diagnosed with a breath (not stool) test
permeability. Low mannitol suggests
malabsorption.
First morning urine; some foods, supplements, • SIBO/IMO is a motility problem
and antibiotics must be avoided for 2-4 days
Takes 5-6 hours before collection • Food poisoning – cytolethal distending toxin B (CdtB) in pathogens triggers
Results not easily comparable between labs Easier collection than stool and blood for production of antibodies that attack vinculin. Vinculin plays a role in cell
Connot be done in people with high glucose many kids adhesion and is found in the interstitial cells of Cajal which drive slow wave
in urine (diabetes) contractions in the migrating motor complex (Kim et al, 2020)
Must stop some medications 3 days prior

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ZONULIN TEST
IBS SMART TEST
• Zonulin protein regulates tight junctions
between cells by triggering
assembly/disassembly of zonulin
• Blood test: measures cytolethal distending toxin B (anti-CdtB) and anti- occluden-1 complexes (ZO-1)
vinculin [antibodies] • Breakdown of tight junctions associated
with increased permeability (Riviere et al,
• Can support IBS-D (rarely IBS-C) diagnosis - although these are clinical 2022)
diagnoses • Fecal zonulin
• Can help understand If past food poisoning has caused a reaction • If elevated, suggests GI permeability
• Much more common than serum testing in
• Not used to diagnose SIBO This Photo by Unknown Author is licensed under CC BY
availability and research

EXAMPLE RESULTS; CULTURE, PCR

MICROBIOME TESTS
• Many options!
• Quantitative assessment of beneficial flora, commensal flora,
dysbiotic flora, and yeast
• Can add on parasitology, protozoa, helminths, virus testing
• Collection: smear up to 3 stool samples (different days) depending on the lab
• Best practice when whole stool not required: catch whole stool and sample from
10-15 locations or collect from several stools on different days and pool them
• Typical diet for at least a week prior to collection
• No probiotics or antibiotics/antimicrobials for at least 2 weeks prior
• Analysis types: culture and microscopy, PCR, next gen sequencing (16S rRNA,
whole genome sequencing or WGS)
• Stool tests microbiota in lumen of colon; there is an inner layer by mucosa that
can only be sampled with biopsy
• Microbiome fluctuates!

EXAMPLE RESULTS EXAMPLE RESULTS

PARASITES, PROTOZOA, WGS
HELMINTHS

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OTHER INFORMATION FROM STOOL

• Not an allergy panel! IgG and IgA testing show
• Occult blood: colorectal cancer, IBD delayed response

• Short chain fatty acids butyrate, acetate, propionate, produced by microbiota • Blood test – serum vs spot test

• Butyrate increases concentration of tight junctions (claudin-1, ZO-1, and occludin) FOOD • These foods are not “forever allergies” but are
causing an immune response
• Butyrate strengthens mucous layer through increased expression of Mucin 2
• Butyrate supports glutathione, can induce differentiation and apoptosis of colon cells, SENSITIVITY • Controversial
support metabolism (Fusco et al, 2023) • I find it helpful. If many food sensitives are
• Fecal calprotectin: inflammation PANEL present, presume GI permeability

• Fecal lactoferrin: inflammation (less common) • Consider evaluation for IgE allergies in those
with asthma, allergies, atopy
• Pancreatic elastase 1: exocrine pancreatic insufficiency
• Scratch test, blood test
• Fecal fat, steatocrit: fat malabsorption
• sIgA: immune function
• Color, undigested food, etc

• Example IgG test • Altered barriers have been demonstrated in

stressed humans and animals
• Typically, tests ~100 foods or
~200 foods • Changes in microbiota do impact barriers –
• Specialized diet tests mucosa, tight junctions
available • Long history of addressing GI healing to support
• Testing available for PERMEABILITY / many symptoms and whole person health
• IgG – sensitivity LEAKY GUT • Why controversy?
• IgA- sensitivity
CONTROVERSY • Barriers fluctuate
• IgE – allergy • Altered barriers seen with symptoms, but
causation is not clearly proven
• Temporary elimination,
• Unclear if this is a “disease” or symptom - if
support integrity, challenge altered barriers cause diseases, or treating heals
foods underlying causes (Camilleri, 2019)
• No [pharmaceutical] treatment

• Support mucus layer

• Support healthy microbiota
• Support tight junction integrity
TREATMENT • Remove toxins/irritants
APPROACHES • Provide supports for epithelial healing
• Decrease inflammatory cascade and
support immune function

NATURAL SUPPORT FOR GI AND WHOLE PERSON HEALING

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SUPPORT OF MUCOUS LAYER SUPPORT OF

HEALTHY
MICROBIOTA
• Lactobacillus species (L. plantarum 299v, L.
rhamnosus GG, and L. acidophilus DDS-1) • Also benefit inflammation, immune
enhance mucin production by goblet cells function, increase butyrate, and
protect barrier
• Demulcent herbs and foods stimulate goblet
cells to produce mucous • Lactobacillus rhamnosus GG
• Lactobacillus acidophilus
• Althaea officinalis (marshmallow), Ulmus rubra
(slippery elm), Glycyrrhiza glabra (licorice), Zea • Lactobacillus plantarum
mays (corn silk), Aloe vera gel • Bifidobacterim infantis
This Photo by Unknown Author is licensed under CC BY-SA
• Slimy foods: nopales, okra, seaweed, sea • E. coli Nissle 1917
vegetables, mushrooms, etc Aleman RS, Moncada M, Aryana KJ. Leaky Gut and the Ingredients That
Help Treat It: A Review. Molecules. 2023;28(2):619. Published 2023 Jan 7. • Bifidobacterium animalis lactis BB-12
doi:10.3390/molecules28020619
(Aleman et al, 2023)

MICROBIOTA SUPPORT: PREBIOTICS

• Taraxacum officinale (dandelion) root, Arctium

lappa (burdock) root, Inula helenium (elecampane)
root
• Jerusalem artichoke, chicory root, onion, garlic,
asparagus, beet, banana, legumes, seaweed
(Davani-Davari et al, 2019)
• Psyllium, flax, chia, pectin, FOS, inulin, β-glucans, guar
gum, resistant starch
• Mucilaginous herbs: Althaea officinalis
(marshmallow), Ulmus rubra (slippery elm),
Glycyrrhiza glabra (licorice), Zea mays (corn silk), NUTRIENTS FOR HEALING INTESTINAL
Aloe vera gel
PERMEABILITY
This Photo by Unknown Author is licensed under CC BY-NC-ND

FAT SOLUBLE VITAMINS

ZINC AND ZINC CARNOSINE
• Improve diversity of healthy microbiota
• Enhance tight junctions (ZO-1, occludin, claudins)
• Modulate inflammation and immune response (Aleman • Zinc
et al, 2023) • Zinc sulfate 110mg 3x.day (!) for 3 months decreased permeability I people with Crohn's
disease using lactose mannitol test (Sturniolo et al, 2001)
• Vitamin A Dose
• Supports permeability, immune function, and gastric mucosa (Scarpellini et al, 2022)
• RDA Men 900 mcg RAE (3,000 IU) / women 750mcg RAE
(2,333 IU) a day (retinol or beta-carotene) • Zinc picolinate 15-30mg once a day with food; for higher/longer term use combine with
copper
• Tolerable upper intake 3,000 mcg (10,000 IU) a day
(NIH, Vitamin A and Carotenoids) • Zinc L-carnosine
• Vitamin D Dose • Mucoprotective – ulcers
• 2,000 IU a day usually good maintenance dose; evaluate • Slow dissociation rate in stomach, antioxidant and anti-inflammatory (Efthymakis and
dose with serum levels Neri, 2022)
• Vitamin K (MK-7) (Chatterjee et al, 2023) • 75mg 1-2x/day
• Vitamin E

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ADDITIONAL BARRIER SUPPORT

Most Regulates Decreases

abundant expression of inflammation
amino acid in tight junction • Glycyrrhiza glabra (licorice) or DGL
GI tract proteins • Protected gut barrier in vitro (Murugan et al, 2022)
L-GLUTAMINE • Demulcent, inflammation modulating, vulnerary
• Colostrum (Dziewiecka et al, 2023)
• Supports immune function, decreases inflammation
• Derived from cows, not dairy free
Synergistic 5 grams in
with water • Doses in studies varied, 5-9 grams a day typical in
probiotics supplements
(Aleman et al, 2023)
1-2x/day
• Immunoglobulin (IgG) 1-5 grams a day

POLYPHENOLS OTHER HERBAL SUPPORT

• Modulate inflammation at least in part due to • Plantago lanceolata/ovale (plantain) leaf

inactivation of NF-κB. NF-κB and associated cytokines
• Camellia sinensis (green tea) leaf
impair GI barrier by disrupting tight junction assembly.
• Quercus alba (oak) inner bark
• Antioxidant activity
• Hibiscus sabdariffa (roselle, hibiscus)calyx
• Increase mucous secretion
• Zingiber officinalis (ginger) root
• Nourish microbiota
• Mentha piperita (peppermint) leaf (Aleman et al,
• Green tea, quercetin, blue/purple foods, turmeric 2023)
• Berberine-containing plants • Calendula officinalis flower
• Decreases inflammation, modulates microbiome • Matricaria chamomilla (chamomile) flower
• Resveratrol (Aleman et al, 2023) • Prunella vulgaris (heal all) areal

This Photo by Unknown Author is licensed under CC BY-SA-NC

GI MUCOSA TOXINS AND ALCOHOL

IRRITANTS
• Single episode of binge drinking (> 4 drinks in a sitting)
• Enterotoxins: lipopolysaccharides from GM- bacteria increased endotoxin and inflammatory cytokines TNFα
and IL-6, most significantly in women (Bala et al, 2014)
• Food prep / hygiene
• Excessive alcohol use negatively impacts microbiota –
• Support a healthy microbiome although challenging to understand if this is also due to
• Mediterranean diet vs standard American diet diet, lifestyle, stress (Engen et al, 2015)
associated with lower LPS (Candelli et al, 2021) • Alcohol reduces ZO-1 and actin microfilaments
• Chemotherapy, Radiation suggesting barrier disruption (d'Angelo et al, 2023)

• Protect mucosa with L-glutamine and other • Probiotics decrease alcohol-related GI symptoms (Engen
demulcents [must comanage to avoid interactions] et al, 2015)
• Support a decrease in alcohol intake
• Iron
• Nervines, acupuncture, therapy, drawing attention to
• Bisglycinate form typically better tolerated than use, support groups, etc
ferrous sulfate

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NON-STEROIDAL ANTI-
INFLAMMATORY DRUGS SAMPLE ASSESSMENT
• Assess diet
• Ibuprofen (Advil, Motrin), naproxen (Aleve), aspirin
• NSAIDS inhibit cox enzymes – but some mucosal damage • Inflammatory foods
may be cox-independent • Nutrient-rich foods
• Cox 1 prostaglandins protect GI mucosa • Polyphenols, essential fatty acids
• Cox 2 prostaglandins mediate inflammation
• Assess for alcohol use, meds/supplements including NSAIDs
• Use can cause heartburn, nausea, dyspepsia, and
abdominal pain – but also perforations, erosions, • Review symptoms for red flags
ulcerations, and acute hemorrhage
• Blood in stool
• Especially in the elderly and chronic users (d'Angelo et al,
2023) • Unintentional weight loss
• Alternatives: turmeric, ginger, white oak bark, Populus sp • Fevers, chills
(birch, aspen, cottonwood)
• Severe abdominal pain
• Topical capsicum , castor oil, peppermint oil, Sr. John’s wort
oil, wintergreen • Fam Hx Celiac, IBS, cancer, autoimmune disorders, cardiometabolic conditions
• California poppy, skullcap, Baikal skullcap, corydalis

TO TEST OR NOT TO TEST SAMPLE STARTING TREATMENT

• Decide if additional testing will be done • Diet

• Mediterranean type diet: as many colors as possible - adequate fiber, protein
• Do you need to adjust probiotics, supplements, diet before tests?
[low FODMAP diet may be helpful]
• Tests I tend to prefer, if there is a strong clinical suspicion • Fish: low mercury, salmon is wild not farmer/Atlantic
• Celiac – blood test must be done WHILE eating gluten. Gold standard test is • Low in processed foods, fried foods, simple starches and added sugars
upper endoscopy with biopsy.
• Adequate water
• Genetic test HLA DQ2 and DQ8 genes can be done if gluten free, but often doesn’t
lead to diagnosis • Decrease alcohol
• SIBO/IMO breath test • Regular movement
• Some type of microbiome assessment (stool) or at least Candida questionnaire
• Walks after meals
• Food sensitivity panel per patient interest • Regular cardio and weights/resistance
• Consider sleep study • Stress management activities and things that bring joy

SAMPLE TREATMENT
[NOT TEST DEPENDENT] PROBIOTICS, PREBIOTICS,
SYNBIOTICS, POST BIOTICS
• L-glutamine 5 grams in water once a day (or combo with
supportive herbs)
• Tea 1 cup 1-2x/day away from medications or supplements • Ask about past response and tolerance
• Marshmallow cold infusion • People with SIBO/IMO may aggravate
• Burdock root • Strains/types
• Licorice
• Lactobacillus rhamnosus GG, Lactobacillus acidophilus, L.
• Aloe juice (not heated) plantarum, Bifidobacterium infantis, B. animalis lactis BB-12
• Carminatives: ginger, fennel, anise, peppermint, spearmint, lemon • E. coli Nissle 1917
balm, cardamom, thyme, cinnamon added to tea, as tincture, or
dietary spices • Bacillus caogulans and spore-based products
• Bitters/sours to support stomach acid & pancreatic secretions – • Saccharomyces boulardii
before meals • Consider prebiotic in formula (combo sometimes called
• Artichoke, turmeric, dandelion leaf/root, angelica, blessed thistle, symbiotic)
burdock
• Postbiotic: metabolites from healthy donors
• Lemon/ACV in water, schisandra, hawthorne, shrubs/fire ciders

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TREATMENT
• Replete nutrients needed for barrier support
THANKS FOR
• Malabsorption is likely
LISTENING!
• Always aim to have as varied a diet as possible
• Variety supports nutrient sufficiency
QUESTIONS?
• We don’t want to encourage restrictive or disordered eating
K.STAGE@SONORAN.EDU
• Fiber is essential – if intolerant, work on healing the root issues
• It may take years to develop intestinal permeability – so treatment can also
take time
• Supporting a healthy microbiome also takes time
• Don’t forget to consider stress/whole person

REFERENCES REFERENCES

• Ahmad R, Sorrell MF, Batra SK, Dhawan P, Singh AB. Gut permeability and mucosal
• Candelli M, Franza L, Pignataro G, et al. Interaction between Lipopolysaccharide
inflammation: bad, good or context dependent. Mucosal Immunol. 2017;10(2):307-
and Gut Microbiota in Inflammatory Bowel Diseases. Int J Mol Sci. 2021;22(12):6242.
317. doi:10.1038/mi.2016.128
Published 2021 Jun 10. doi:10.3390/ijms22126242
• Aleman RS, Moncada M, Aryana KJ. Leaky Gut and the Ingredients That Help Treat It:
• Camilleri M. Leaky gut: mechanisms, measurement and clinical implications in
A Review. Molecules. 2023;28(2):619. Published 2023 Jan 7.
humans. Gut. 2019;68(8):1516-1526. doi:10.1136/gutjnl-2019-318427
doi:10.3390/molecules28020619
• Chatterjee K, Mazumder PM, Sarkar SR, et al. Neuroprotective effect of Vitamin K2
• Bala S, Marcos M, Gattu A, Catalano D, Szabo G. Acute binge drinking increases
against gut dysbiosis associated cognitive decline. Physiol Behav. 2023;269:114252.
serum endotoxin and bacterial DNA levels in healthy individuals. PLoS One.
doi:10.1016/j.physbeh.2023.114252
2014;9(5):e96864. Published 2014 May 14. doi:10.1371/journal.pone.0096864
• Cornick S, Tawiah A, Chadee K. Roles and regulation of the mucus barrier in the gut.
• Buckley A, Turner JR. Cell Biology of Tight Junction Barrier Regulation and Mucosal
Tissue Barriers. 2015;3(1-2):e982426. Published 2015 Apr 3.
Disease. Cold Spring Harb Perspect Biol. 2018;10(1):a029314. Published 2018 Jan 2.
doi:10.4161/21688370.2014.982426
doi:10.1101/cshperspect.a029314

REFERENCES REFERENCES

• Davani-Davari D, Negahdaripour M, Karimzadeh I, et al. Prebiotics: Definition, Types, • de Vos WM, Tilg H, Van Hul M, Cani PD. Gut microbiome and health: mechanistic
Sources, Mechanisms, and Clinical Applications. Foods. 2019;8(3):92. Published 2019
Mar 9. doi:10.3390/foods8030092 insights. Gut. 2022;71(5):1020-1032. doi:10.1136/gutjnl-2021-326789

• Dziewiecka H, Buttar HS, Kasperska A, et al. A Systematic Review of the Influence of • Engen PA, Green SJ, Voigt RM, Forsyth CB, Keshavarzian A. The Gastrointestinal
Bovine Colostrum Supplementation on Leaky Gut Syndrome in Athletes: Diagnostic Microbiome: Alcohol Effects on the Composition of Intestinal Microbiota. Alcohol Res.
Biomarkers and Future Directions. Nutrients. 2022;14(12):2512. Published 2022 Jun 17. 2015;37(2):223-236.
doi:10.3390/nu14122512
• Farré R, Fiorani M, Abdu Rahiman S, Matteoli G. Intestinal Permeability, Inflammation
• Efthymakis K, Neri M. The role of Zinc L-Carnosine in the prevention and treatment of and the Role of Nutrients. Nutrients. 2020;12(4):1185. Published 2020 Apr 23.
gastrointestinal mucosal disease in humans: a review. Clin Res Hepatol Gastroenterol. doi:10.3390/nu12041185
2022;46(7):101954. doi:10.1016/j.clinre.2022.101954
• Fusco W, Lorenzo MB, Cintoni M, et al. Short-Chain Fatty-Acid-Producing Bacteria:
• d'Angelo M, Brandolini L, Catanesi M, et al. Differential Effects of Nonsteroidal Anti- Key Components of the Human Gut Microbiota. Nutrients. 2023;15(9):2211. Published
Inflammatory Drugs in an In Vitro Model of Human Leaky Gut. Cells. 2023;12(5):728.
Published 2023 Feb 24. doi:10.3390/cells12050728 2023 May 6. doi:10.3390/nu15092211

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REFERENCES REFERENCES

• Kim JH, Nam SJ, Park SC, et al. Association between interstitial cells of Cajal and anti-
vinculin antibody in human stomach. Korean J Physiol Pharmacol. 2020;24(2):185-191. • Ogobuiro I, Gonzales J, Shumway KR, Tuma F. Physiology, Gastrointestinal. In:
doi:10.4196/kjpp.2020.24.2.185 StatPearls. Treasure Island (FL): StatPearls Publishing; April 8, 2023.

• Murugan SK, Bethapudi B, Raghunandhakumar S, et al. A flavonoid rich standardized • Pandey P, Rastogi S, Lawrence A, Agrawal GG. Development and validation of an
extract of Glycyrrhiza glabra protects intestinal epithelial barrier function and ama instrument for assessing the disease activity on the basis of constitutional
regulates the tight-junction proteins expression. BMC Complement Med Ther. features in Amavata (Rheumatoid Arthritis). J Ayurveda Integr Med.
2022;22(1):38. Published 2022 Feb 7. doi:10.1186/s12906-021-03500-1 2023;14(2):100689. doi:10.1016/j.jaim.2023.100689

• National Institutes of Health. Vitamin A and Carotenoids. Vitamin A – Health • Park J, Choi TJ, Kang KS, Choi SH. The Interrelationships between Intestinal
Professional. Updated March 10, 2025. Accessed April 29, 2025. Permeability and Phlegm Syndrome and Therapeutic Potential of Some Medicinal
https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/ Herbs. Biomolecules. 2021;11(2):284. Published 2021 Feb 15.
doi:10.3390/biom11020284
• Newman Turner R, Dick-Kronenberg L, Rogers C, and Finnel J. Nature Cure Volume 1,
The Foundations of Naturopathic Medicine. Naturopathic Medicine Academy; 2025

REFERENCES

• Riviere AJ, Smith KS, Schaberg MN, Greene MW, Frugé AD. Plasma and fecal zonulin
are not altered by a high green leafy vegetable dietary intervention: secondary
analysis of a randomized control crossover trial. BMC Gastroenterol. 2022;22(1):184.
Published 2022 Apr 12. doi:10.1186/s12876-022-02248-3
• Scarpellini E, Balsiger LM, Maurizi V, et al. Zinc and gut microbiota in health and
gastrointestinal disease under the COVID-19 suggestion. Biofactors. 2022;48(2):294-
306. doi:10.1002/biof.1829
• Sturniolo GC, Di Leo V, Ferronato A, D'Odorico A, D'Incà R. Zinc supplementation
tightens "leaky gut" in Crohn's disease. Inflamm Bowel Dis. 2001;7(2):94-98.
doi:10.1097/00054725-200105000-00003

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Overview of our time together

Menopause as a • Menopausal Changes

Neuroinflammatory and
• Etiology of vasomotor symptoms
• Brain changes

Hormonal Event
• Inflammation/ Immune changes
• Cardiovascular changes
• Structural changes
Medicines from the Earth Herb Symposium 2025 • Mood changes
• Break
Wendy Warner, MD, ABIHM, IFMCP • Looking at traditional formulas, their components and known science
www.WendyWarnerMD.com
• Break
@wendywarnermd
• Final Q&A and Wrap up

Men age differently—Older Dads

Before we get
started
Can we first look at why menopause evolved?

Very few mammals have a long post-reproductive

• As females age, their distant relatives become
replaced by their offspring and grand-offspring in life
their immediate group

Evolution of • Older females suffer costs if reproducing at the

same time as their daughters, which could lead to
reproductive restraint
• Of 52 placental mammals studied, only humans, killer whales, and pilot whales live a significant
portion of their lives post-reproduction

Menopause • This restraint would need to be coupled with

• In numerous animals, the ability to help others did NOT lead to this
added benefit to the group with age, or post- • Older age in mammals does NOT by itself lead to this
reproductive life would be short • In the three species where menopause has evolved, it is a combination of reproductive conflict
and intergenerational benefit in later life that seems to be the key

• Ecol Evol. 2018 Jan 31;8(5):2482-2494

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• Hadza of northern Tanzania—grandmas were the ones who gathered the tubers, an
important source of food for the families and impossible for the kids to gather
• Important for the health of the grandmas and the ability of kids to make it to adulthood
• Allowed moms to focus on having more children
• As grandmas aged, they sat with kids while moms foraged

Historical View of Menopause Traditional View of Menopausal

Hormone Changes
• Symptoms arise from dropping estrogen levels
• Decreasing levels of inhibin B lead to increased levels of FSH
• Estrogens decline as ovarian reserve declines
• Estradiol levels decline and FSH levels rise, but concentrations vary;
• Linked to FSH levels measurements are of limited diagnostic value
• Declining libido is a function of testosterone decline, • At time of final menses, estradiol is 50% of mid-reproductive years
though estrogen also needs to be available and FSH is 50% of what it ultimately is postmenopausally

It’s all about estrogen!

Medicine Volume 34, Issue 1 , Pages 27-30, 1 January 2006

Problems with this approach

Brain
Chemistry

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©2023 The Institute for Functional Medicine

©2023 The Institute for Functional Medicine

Cortisol Dysregulation Is Associated With Daily Diary-Reported Hot

Flashes Among Midlife Women Clin Endocrinol 85 (4), 645-51 Oct 2016

More frequent, severe and bothersome flashes with

higher cortisol

What are the other drivers for Higher hot flash frequency with lower mean cortisol when
waking plus 30 minutes

this? Greater hot flashes trended toward higher bedtime

cortisol

Trend toward diminished diurnal variation of cortisol with

greatest number of flashes

How Is Glucose
Involved?

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GLUT-1
Elevated blood glucose leads to fewer flashes; it’s the • With brain activation, glucose needs immediate increase
drop that makes it happen • This glucose supplied through increased production of glucose
transporter 1 (GLUT1) at the blood–brain barrier (BBB) and through
vasodilation
• Estrogen stimulates production of GLUT1
According to this model, increased blood glucose • As estrogen declines at menopause, upregulation of GLUT1 is less
levels overall suppress hot flash frequency; efficient
postprandial hypoglycemia leads to increased flashes • As a consequence, neurobarrier coupling overcompensates with an
excess neurovascular response, or a hot flash.
Dormire SL. Biol Res Nurs.2009Jan;10(3):241-7. doi: 10.1177/1099800408324558. PMID: 19017668;
PMCID: PMC2767392

SWAN study
• Hot flashes were associated with a higher HOMA index, an estimate
of insulin resistance, and to a lesser extent higher glucose
• Not explained by potential confounders, including BMI, nor by E2 or
FSH
Brain Inflammation
• J Clin Endocrinol Metab. 2012 Oct;97(10):3487-94. doi: 10.1210/jc.2012-1410. Epub 2012 Jul 31. PMID: 22851488; PMCID: PMC3462945.

Estrogen Function in the Brain

• Memory formation
• Influences neuroinflammation

Biomedicines 2022, 10(4), 861; https://doi.org/10.3390/biomedicines10040861

Biomedicines 2022, 10(4), 861; https://doi.org/10.3390/biomedicines10040861

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Sources of Estrogen in the Brain

• From the periphery through the BBB
• Locally transformed from androsterone
• Produced directly from cholesterol by neurons or glial cells
Physiology of Menopause:
• Regulation of steroidogenesis in the brain is independent from the
periphery
Brain Remodeling

ER alpha and ER beta ER beta

Prefrontal cortex: Thalamus:
Executive function and working Sensory integration
memory

Menopause as a Neurologic Transition Basal forebrain:

Learning and memory
Posterior cingulate:
Default mode network,
working memory, task
preparation
Hypothalamus:
Regulation of temperature, sleep,
energy, balance and food intake
thalamus
• Neurological symptoms that emerge during perimenopause are indicative of disruption Amygdala:
Emotion and motivation
Prefrontal Posterior

in multiple estrogen-regulated systems and affect multiple domains of cognitive cortex

hypothalamus
cyngulate

hippocampus
function Hypothalamus:
Basal forebrain
Information processing and short
• Thermoregulation Term memory
amygdala
Raphe
nucleus
• Sleep Raphe nucleus: Locus
• Circadian rhythms Serotonergic system
Affect and mood
ceruleus

• Sensory processing
Locus ceruleus:
• Estrogen receptor network becomes uncoupled from the bioenergetic system Adrenergic system
Attention, arousal, anxiety

Nat Rev Endocrinol. 2015 Jul;11(7):393-405

Adapted from Nat Rev Endocrinol. 2015 Jul;11(7):393-405

• Ordered and sequential process, during which the brain seems to

undergo dismantling of the connections between the estrogen
• Estrogen signaling through this network of receptors ensures that receptor network and the bioenergetic system
neurons can generate sufficient energy to meet demand
• The disengagement of the estrogen receptor network from the
bioenergetic system in the brain is also associated with a release of
• Changes in either the availability of estrogen or its receptor network suppression of enzymes required to metabolize ketone bodies
can affect intracellular signaling and neural circuit function • This loss of suppression enables the emergence of an adaptive
compensatory response in the brain that is necessary to utilize
ketone bodies as an alternative fuel

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In some studies…
• After the menopause, women who began estrogen replacement therapy
during perimenopause or in their menopausal year, had preserved glucose
metabolism in brain regions with estrogen-dependent neurological
functions, such as hippocampus, entorhinal cortex, medial temporal
cortex and posterior cingulate
• After the menopause, glucose metabolism declined in estrogen-
dependent regions of the brain, but increased in regions, such as pons,
caudate and precuneus in women who did not receive estrogen therapy
during perimenopause and menopause

https://doi.org/10.1371/journal.pone.0185926

• Shifts in energy sources, from glucose

metabolism to fatty acid metabolism and
ketone bodies
Alterations in Brain
Metabolic Status • This strategy serves as an adaptation to
with aging and
neurodegenerative
sustain ATP production but leads to:
• increased free radical production Physiology of Menopause:
disorders • lipid peroxidation
• oxidative stress Inflammation and Immune
• endoplasmic reticulum (ER) stress
• Production of damage-associated
Changes
molecular patterns further induces
chronic systemic inflammation.

Premenopausal chronologic aging Perimenopausal endocrinologic aging Menopausal aging

Decreased IGF signaling Decreased IGF signaling, decreased Decreased IGF signaling Premenopause Perimenopause Menopause
AMPK signaling
Decreased glucose metabolism: Decreased glucose metabolism: Decreased glucose metabolism:
Lower uptake and glycolysis Lower uptake and glycolysis, lower ox Lower uptake and glycolysis, lower ox
phos phos

Increased chronic low-grade Increased fatty acid and ketone body Increased fatty acid beta-oxidation
inflammation: metabolism
Increased NFKB, TNF signaling
Increased innate immune response Increased H2O2 production and lipid Increased oxidative stress: increased
peroxidation ROS, H2O2, lipid peroxidation, myelin
debris
Increased IL 1b and IL 18 Increased cyclooxygenase activation Increased interferon response,
and decreased NFKB increased MHC-complement system,
increased microglia phagocytic
senescence
Increased microglia and astrocyte
activity, increased peripheral T cell
activated autoimmunity, increased IL8
and TNF alpha Adapted from Wang V, et al. F1000 Faculty Rev-68. 2020 Jan 30 Adapted from Wang V, et al. F1000 Faculty Rev-68. 2020 Jan 30

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• HRT/ ERT can mitigate menopause-related neuroinflammation

• Down-regulates inducible nitric oxide synthase (iNOS) and
cyclooxygenase-2 (COX-2) expression

Physiology of Menopause:
• Reduces TNF-α, IL-1β, macrophage inflammation, protein-2
secretion, and ROS production
• Mediates its effect through both intracellular ERα and ERβ, found
in microglia and astrocytes.
Cardiovascular Changes

• Inflammation is directly linked to CVD risk and • Women: first myocardial infarction roughly 10 years later than men
development
A Few Vascular • Vascular disease is an immune response
• More likely to have longer door-to-balloon times
• Lower rate of prescribed guideline directed medical therapy
Disease Basics • Women in general are more likely to have higher
inflammatory markers than men
• Higher in-hospital mortality
• Even after a successful percutaneous coronary intervention (PCI),
• Most studied markers of inflammation in CVD women with acute coronary syndrome (ACS) have a 20% higher
include
• IL-1β, IL-6, IL-8, IL-10, and IL-12 and IL-18 Stats about adjusted mortality risk in the short term, and at 1 year for those over age
45, a 74% survival rate vs. 81% in men
• Mediate inflammation and modulate
immunity. Women and • For those who survive an ACS, there is a higher risk of recurrent MI, HF,
and death
• IL-6 receptor signaling pathways: causal role in
the development of myocardial infarction, stroke
and atrial fibrillation
Heart • In women under 50 years old there is twice-higher mortality than men
• Overall, short- and long-term mortality is 40% higher in women

• CRP: Disease • Those with an annual household income of < $20,000 have a 4.91-fold
higher relative risk ratio of MI and cardiovascular death than those in
• An inflammatory marker higher-income brackets
• A mediator of endothelial dysfunction and • 26.8% of female-headed households live below the US’s poverty
atherosclerotic plaque formation threshold
• Production stimulated by cytokines, such as
IL-6 and TNF-α. Also from local • Curr Atheroscler Rep. 2021 Aug 4;23(10):56
inflammatory conditions like gingivitis or
even utis

Risk Factors
• Low estrogen concentrations associated with
higher levels of cytokines such as IL-1, IL-6
and increased TNF-α production in T cells • Depression:
• Increased risk for incident CAD, MI, and mortality following a cardiac event in
• Progesterone acts on its receptors located in both sexes
Hormones vascular endothelial and smooth muscle to • Independent risk factor for poor prognosis in patients with ACS
• Direct impact
and Heart promote cardiovascular effects similar to
estrogen
• Increased platelet aggregation, inflammation, and autonomic nervous system
dysregulation
Disease • Progesterone increases endothelial nitric
• Indirect mechanism
• Unhealthy lifestyle behaviors
oxide synthase (eNOS) which can improve NO • Adverse pregnancy outcomes: increased risk of HF, CAD, and
bioavailability and downstream vasodilation cardiovascular mortality
• Preterm labor, gestational diabetes, and hypertensive disorder of pregnancy,
• Does NOT happen with synthetic progestins
• Systemic inflammatory disorders: two- to three-fold higher risk of MI
and increased CVD mortality out of proportion to traditional risk factors
• Systemic lupus erythematosus and rheumatoid arthritis.
• Curr Atheroscler Rep. 2021 Aug 4;23(10):56

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Breastfeeding decreases Prematurity

CVD risk in later life
Gender PCOS
specific Early menarche
Calcifications in risk factors
mammogram, even when for CVD Adverse pregnancy outcomes
benign, are associated with
increased CVD risk Early menopause

Women vs men
• Less obstructive CAD, more preserved left ventricular ejection
fraction despite higher rates of myocardial ischemia
• High incidence of microvascular dysfunction
• Higher incidence of depression/ DM which likely has impact
• Progress in Cardiovascular Diseases Volume 84, May–June 2024, Pages 34-42

• More diffuse pattern of atherosclerosis

• Fewer vascular calcifications Biomed Res Int. 2024 Oct
.
• More frequent soft atherosclerotic plaques, which are more 29;2024:2023620

vulnerable to rupture
• https://doi.org/10.1016/j.maturitas.2023.02.004

Skeletal Muscle

• Estradiol receptors at the fiber level

• Estradiol stimulates muscle regeneration by stimulating muscle satellite cells (stem

Physiology of Menopause:
cells)
• Proinflammatory cytokines degrade muscle proteins and muscle’s ability to respond
to damage

Structural Changes
• Front. Endocrinol., Volume 12, 18 May 2021

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Bone and muscle changes are related

Estrogen • Impacts protein synthesis/ degradation
signaling pathways • Bone adapts its mass, architecture, and strength to changes in stress and strain
affects • Impacts contractile proteins
• Impacts muscle mitochondrial function
induced by gravitational loading and muscle activity
• Accordingly, adaptations of bone and muscle tissue to reduced or increased loading
muscle • Impacts muscle satellite cell number and
function, likely via apoptosis
conditions coincide.
• Muscle mass and muscle strength changes are independent, suggesting impact of
quality and neuronal changes and muscle quality
• Studies show that early in perimenopause, activity levels have large impact on bone
quantity • Sports Medicine (2022) 52:2853–2869
and muscle mass

• https://doi.org/10.1002/jcsm.12547

Skin changes Mucosal Surfaces

• Oral, gut and vaginal mucosa all respond to estrogens
• Rapid loss of collagen (1/3 of total in first 5 years, 2.1% loss per year for the next 15 • Estrogen deficiency impacts mucosal maturation
years). Not related to chronologic age • Oral
• Increased degradation of elastin • Increased incidence burning mouth syndrome, oral lichen planus
• Increased incidence of psoriasis • Salivary glands are hormone dependent (may affect dental caries)
• Increased incidence keratoderma climactericum (dryness, peeling on feet primarily) • Vaginal
• Less tissue elasticity, greater mucosal fragility
• Genitourinary syndrome
• Clin Exp Dermatol. 2022 Dec;47(12):2117-2122.
• doi.org/10.3389/frph.2021.779398
• doi: 10.3390/ijerph19010253

• Brain steroidogenesis is independent of peripheral steroidogenesis; brain steroid levels do not correlate
with plasma steroid levels in animals
• In brain, estradiol regulates glucose metabolism, glycolysis, oxidative phosphorylation and subsequent
ATP generation in neurons

Alzheimer’s Risk • Genetic studies have identified variants of the gene encoding for the aromatase enzyme that are
associated with an increased risk for AD
• These genetic variants may result in decreased estradiol synthesis in brain, which, together with decreased
serum estradiol levels in post-menopausal women may increase the risk for AD
• Aromatase expression is indeed increased in prefrontal cortex of patients with severe AD, a phenomenon
that has been interpreted to be part of a “rescue program”
• Imaging: Most studies indicate increased hippocampal or amygdala volumes during the late follicular
phase, when estradiol levels are rising and progesterone is low. direct association between higher estradiol
levels and larger hippocampal volume . Prefrontal cortex volume and thickness also appear to be
positively associated with estradiol levels
• Estrogen withdrawal during menopause has been linked to accelerated brain cellular aging, possibly
increasing risk of neurodegenerative events and AD later in life
• Front Aging Neurosci. 2022 Jul 19;14:948219.

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Risk is different between men and women

Estrogen’s role in
• Underlying mechanisms of vulnerability to AD are different for women and men
• Women start to show signs in the very early perimenopausal hormone transitions

mood modulation
• Bioenergetic changes in women’s brains occur earlier than men’s
• Trials using estradiol as opposed to conjugated equine estrogen (CEE), found that treatment
helped stabilize or improve cognition in women with AD
• PhytoSERM, a preparation of genistein, daidzein, and S-equol, has an 83-fold selective
affinity for estrogen receptor (ER) β and may promote neuronal survival and estrogenic
mechanisms in the brain without exerting feminizing activity in the periphery.

• Expert Rev Neurother. 2018 Sep;18(9):689-691

• Menopause. 2018 Feb;25(2):191-196

WHAM study
Estrogen regulates: (What Happens After Menopause)
• Synthesis and metabolism of dopamine, serotonin, norepinephrine
• Also glutamate, GABA, acetylcholine, opioid pathways • 2017, stated objective was to measure sexual function after early BSO
for prevention of ovarian cancer
• Maintains neural circuits and synapses
• Secondary objectives were measurements of menopausal symptoms,
• Brain levels of estrogens not related to systemic levels (so not reflected in blood
tests)
QOL, effects on bone, cardiovascular changes and sleep issues
• Australia; subjects were carriers of BRCA1, BRCA2, BRIP1, RAD51C,
Lynch syndrome
• “We do not expect RRBSO to affect mental health”

• 2015;32:539–549. doi: 10.1002/da.22391.

• Aust N Z J Psychiatry. 2024 Aug;58(8):636-640. doi: 10.1177/00048674241253944 • BMJ Open. 2017 Nov 14;7(11):e018758. doi: 10.1136/bmjopen-2017-018758. PMID: 29138210; PMCID: PMC5695307

WHAM results: Allostasis

• allostasis : active process by which the body responds to daily
• Conclusions: events and maintains homeostasis
• RRBSO leads to a rapid increase in clinically significant depressive • allostatic load or overload : the wear and tear that results from
and anxiety symptoms despite Hormone Therapy use either too much stress or from inefficient management of
allostasis, such as not turning off the response when it is no
longer needed

• 01 JUL 2007https://doi.org/10.1152/physrev.00041.2006

• Gynecol Oncol. 2021 May;161(2):527-534. doi: 10.1016/j.ygyno.2021.02.001.

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Allostatic load during perimenopause

• Sleep restriction to 4 h of sleep per night
• increases blood pressure
• decreases parasympathetic tone
• increases evening cortisol and insulin levels
• promotes increased appetite (elevation of ghrelin, decreased levels of leptin)
• Also, proinflammatory cytokine levels increased, along with decreased performance in
tests of psychomotor vigilance
• has been reported to result from restriction to 6 h/night
• Allostatic overload resulting from chronic stress (animal models) causes
• atrophy of neurons in hippocampus and prefrontal cortex (memory, selective
attention, and executive function)
• hypertrophy of neurons in amygdala (fear, anxiety, aggression)
• Ability to learn, remember and make decisions may be compromised by chronic stress
and may be accompanied by increased levels of anxiety and aggression.
FIG. 1. Central role of the brain in allostasis and the behavioral and physiological response to stressors. [From McEwen (211), copyright 1998 Massachusetts
Medical Society.]

• 01 JUL 2007https://doi.org/10.1152/physrev.00041.2006

Stress, Anxiety and Menopause Stress, Anxiety and Menopause

• About half of all women report unspecific anxiety, much like lasting premenstrual symptoms
• Stress results from the imbalance between environmental demands and personal resources
• Many patients do not report anxiety as a leading symptom, but rather
to deal with these demands somatic complaints (e.g., pain, sleep disorders)
• It is the cognitive appraisal of the event as taxing or exceeding a person's resources that • Rule out other disorders such as underlying general anxiety disorder, major
causes a negative affective state. depression, personality disorders, as well as physical diseases
• Stress is closely linked: depression, cardiovascular disease, cancer, metabolic syndrome, • Somatic differential diagnoses
later life mild cognitive impairment (MCI), dementia, and Alzheimer's disease, and rapid • Pulmonary disorders (e.g., bronchial asthma, COPD, respiratory insufficiency)
biological aging
• Cardiovascular diseases (e.g., angina, myocardial infarction, arrhythmias)
• Menopausal symptoms such as hot flushes are perceived as more bothersome by stressed • Neurological disorders (epilepsy, migraine, multiple sclerosis, other causes of vertigo)
women
• Otorhinolaryngological disorders (e.g. peripheral vestibular disorder, Meniere's
• SWAN study: 42 % of women reported moderate and 19 % high stress in the previous week disease, benign paroxysmal positional vertigo)
• Endocrine disorders (e.g., hypoglycemia, hyperthyroidism)
• Maturitas December 2022, Volume 166 P1-13
• Side effects of medications.

• Women with the most severe menopausal

symptoms were more likely to report 4 or
more adverse childhood experiences
• Women who reported any abuse in the past
ACEs, Inflammation, Mood, Memory
year had 2.96 times the odds of reporting
ACE 1-3 • Inflammation links ACEs and verbal memory for high ACE women during
• Increased to 6.73 for ACE≥4 perimenopause
Association of • Women who reported greater scores for
depression had 1.94 greater odds of
• Reducing inflammation for these individuals may have positive impact on verbal
memory across the menopause transition
ACEs and reporting ACE 1-3 and 4.48 greater odds of
reporting ACE≥4 • Advancing menopause stage was associated with worse performance on immediate
Anxiety at • Women who reported higher anxiety had
1.73 greater odds of also reporting ACE 1-3
verbal recall and delayed verbal recall
• During perimenopause, higher ACE exposure was associated with worse immediate
Menopause and 4.74 greater odds of reporting ACE≥4
• Screening women with severe menopausal
verbal recall at higher levels of TNF-α
• Measured CRP, IL-6, IL-1β, and TNF-ɑ
symptoms for childhood adversity
• *We understand that mood is also about inflammation in the brain
• Victims of childhood adversity may have
persistent alterations in serotonergic
• Brain Behav Immun Health. 2022 Jan 5;20:100411. doi: 10.1016/j.bbih.2022.100411
pathways that control executive function

Maturitas. 2021 Jan;143:209-215. doi: 10.1016/j.maturitas.2020.10.006

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Gut Microbes and Mood

• Pathways gut microbiota could influence the brain and mental health
• The vagus nerve
• Microbial regulation of neuro-immune signaling
• Microbe-mediated tryptophan metabolism
• Microbial control of neuroendocrine function
• Microbial production of neuroactive compounds
• Production and regulation of serotonin, dopamine, glutamate
• In individuals with social exclusion:
• Prevotella was increased
• Firmicutes/Bacteroidetes ratio and the abundance of Faecalibacterium spp.
were significantly reduced
• In individuals with generalized anxiety disorder:
• Lower microbial richness and diversity
• Reduced levels of Firmicutes spp. and microbiota that produce SCFAs
• More Fusobacteria and Bacteroidetes
• Gut microbiota genera positively correlated with anxiety

• Nutrients. 2023 Jul 23;15(14):3258. doi: 10.3390/nu15143258. PMID: 37513676; PMCID: PMC10384867
Nutrients. 2023 Jul 23;15(14):3258
doi: 10.3390/nu15143258. PMID: 37513676; PMCID: PMC10384867

Summary of Drivers of Menopausal Sx

• Blood sugar dysregulation
How Traditional • Stress hormone imbalances
Formulas Stack Up • Immune dysregulation
• Shift from estradiol (strong estrogen) to estrone (weak estrogen)

Common Herbs in Menopausal Formulas

• Vitex • Motherwort Chemical components: Iridoid Glycosides
• Black cohosh • Skullcap (lateriflora)
• Dong quai • Blue Vervain • Anti-inflammatory • Found in
• Milky oats (Avena sativa) • Processed Rehmannia • Hepatoprotective
• Vitex
• Blocks inflammation
• Shatavari • Passionflower • Blocks lipid peroxidation • Motherwort
• Night-Blooming Cereus • Wild Yam Dioscorea villosa
• Blocks fibrosis • Skullcap
• Possibly protects mitochondria
• Blue vervain
• Licorice Glycyrrhiza uralensis • Sarsaparilla Smilax officinalis • Neuroprotective
• Decreases production and improves clearance of • Processed rehmannia
• Rheum raponticum amyloid beta
• Hypoglycemic

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Chemical components: Labdane diterpenes Chemical components: Flavonoids

• Anti-inflammatory • Found in • Antioxidant • Found in
• Inhibits NFKB • Vitex • Vitex
• Inhibits lipid oxidation • Dong quai
• Modulates arachidonic acid • Ginger family • Night blooming cereus
metabolism
• Motherwort
• Reduces nitric oxide production • Skullcap
• Genistein has been shown to affect • Blue vervain
expression of estrogen receptors • Licorice
• Sarsaparilla
• Rheum raponticum

Most phytoestrogens act on

ER beta > ER alpha

Chemical components: Triterpene glycosides

Flavones and flavanones inhibit
Aromatase, decreasing estradiol
production from androgens • Anti-inflammatory • Found in
• Immune modulatory • Black cohosh
• Licorice
Int J Mol Sci. 2017 Jun 28;18(7):1381

Chemical components: isoferulic acid Chemical components: tannins

• Antioxidant • Found in • Antioxidant • Found in
• Anti-inflammatory • Black cohosh • Anti-inflammatory • Black cohosh
• Dong quai • Motherwort
• Hepatoprotective • Immune modulatory
• Skullcap
• Glucose modulating
• Neuroprotective

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Chemical components: steroidal saponins

• Anti-inflammatory
Chemical components: quercitin and derivatives
• Found in
• Antihypertensive
• Shatavari • Isorhamnetin • Found in
• Shatavarins
• Wild yam • Antioxidant • Night blooming cereus
• Bind to estrogen, progesterone receptors
• sarsaparilla • Anti-inflammatory
• Sarsapogenin
• Neuroprotective
• Passionflower
• Lowers IL1 beta, IL 6, TNF alpha
• Improves amyloid beta breakdown and clearance • Glucose regulating • Sarsaparilla
• Reduces neuronal loss in hippocampus • Anti-bone resorptive • Rheum raponticum
• Slows osteoclast activity
• Rutin (quercitin glycoside)
• Protects vascular endothelium from damage of high
glucose levels • Anti-inflammatory
• Diosgenin • Activates AMPK in muscle for glucose
• Lowers COX, TNF alpha uptake
• Neuroprotective • Activates NOS for cardiac protection
• Precursor for steroid hormone production • Antioxidant
• Antioxidant
• Low bioavailability, likely gets activated in
• Blood sugar modulating
colon so need good microbiome
• Prevents liver fibrosis

Components by Plant: Vitex Components by Plant: Black Cohosh

Iridioid glucosides Triterpene glycosides

Labdane diterpenes Isoferulic acid

Flavonoids Salicylic acid

Tannins

Polyphenols, Antioxidants

Immunomodulatory, Anti-inflammatory

Components by Plant: Dang gui Components by Plant: Milky Oats

Ferulic acid C-glycosyl flavones

Coumarins (vasodilator, cns stim, antispasmodic) Avenacosides (spirostanol glycosides)

Flavonoids

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Components by Plant: Night Blooming

Components by Plant: Shatavari
Cereus
Diosgenin Flavonoids: Isorhamnetin, solasonine, Cacticin, Rutin

Racemoside A & B- Phenethylamine alkaloids: Hordenine (cardiotonic), Tyramine (cns stim) (related)

Shatavarin I-X Diterpene bitters (pircosalvin/carnosol, carnosolic acid

Sarsasapogenin Flavonoids (savigenin, hispidulin, luteolin, etc)

Shatavaroside A & B Phenolic acids (rosmarinic, caffeic, labiatic)

Salviatannin (a catechin)

Components by Plant: Motherwort Components by Plant: Scullcap (lateriflora)

Irioids Flavonoids (baicalein, scutellarein, wogonin

Labdane diterpenes Iridoids (incl catalpol)

Flavonoids (apigenin, kaempferol, quercetin glucosides) Tannins

Caffeic acid GABA

Alkaloids (tachydrine, betonicine, turicin, leonurine

Tannins

Components by Plant: Blue Vervain Components by Plant: Processed Rehmannia

Iridoid glycosides Irioid glycosides

Hastatoside, Verbenalin (both nervine) Ajugol-hypoglycemic, anti-inflammatory

Aucubin-neuroprotective Ajugoside-antioxidant

Verbenaloside ( a glycoside) Catapol-hypoglycemic, anti-inflammatory

Flavonoids and Phenolics (all anti-inflammatory) Rehmannioside A-D neuroprotective, anti-inflammatory

Verbascoside Rehmaionosides A,B,C (ionone glycosides)

Leucosceptoside A may act on both ERα and ERβ receptors

Martynoside

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Components by Plant: Passionflower Components by Plant: Wild yam

Flavonoids (apigenin, chrysin, kaempferol, luteolin, quercitin, rutin, orentin, vitexin) Steroidal saponins

Harmane alkaloids (trace amounts, psychoactive) Dioscin

Dioscorin-antioxidant

Diosgenin-antiinflammatory

Parvifloside

Protodeltonin, deltonin (antitumor)

Steroidal glycosides

Dioscoreavillosides A & B

Components by Plant: Licorice (G. uralensis) Components by Plant: Sarsaparilla

Steroidal saponins

Triterpenoids Sarsparilloside

Glycyrrhizic acid-anti-inflammatory Sarsasapogenin-hypoglycemic

Glycyrrhetinic acid-antitumor Smilagenin-neuroprotective

Glycyrrhizin (triterpenoid saponin)-antiallergic Sarsaponin -binds endotoxins

Flavonoids and phenolics Smilasaponin

Diosgenin-antiinflammatory
Echinatin-hepatoprotective Isoliquiritigenin-antioxidant
Tigogenin-antitumor
Genistein-antitumor Neoliquiritin-anti-inflammatory
Flavonoids
Glabridin-antitumor Liquiritigenin-hepatoprotective
Quercetin-antiinflammatory

Components by Plant: Rheum raponticum

Hydroxystilbenes

Rhaponticin
Other Menopausal
Concerns
desoxyrhaponticin

Aglycones

Rhapontigenin

desoxyrhapontigenin

Flavonoids

Hyperoside

Quercitin glycosides

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Definition

• Compromised bone density predisposing individual

to increased risk of fracture

• Fastest drop in bone density in first few years after

Osteoporosis final period
• Tends to stabilize at that point
• At increased risk if: celiac, renal disease, long
term use of PPI’s, other sources of nutritional
deficiency, smoker, frequent steroid use
(remember steroid inhalers!)

DEXA scans
Hormones and inflammation
• Understand what information they actually
give
• High cortisol inhibits osteoblasts • Risk of fracture, which might not be rate
of fracture
• Low DHEA/ testosterone problematic (they • Measures mineralization but not
stimulate osteoblasts) protein/collagen support
• Higher CRP associated with osteoporosis • Can’t compare one manufacturer’s
machine to another
• What is that about?

• Some evidence autoimmunity also a factor • FRAX scores (online assessment tool)

REMs scans Prevention and Treatment of

Osteoporosis
• Reduce bone loss
• These are ultrasound, not radiation • Phytoestrogens: soy, alfalfa, red clover, kudzu
• Clearly are measuring both mineralization and • Dietary isoflavones: beans, other legumes
bone matrix/collagen scaffolding • Inhibit osteoporosis
• Were better at predicting fractures in obese • Du Zhong, processed rehmannia, horsetail,
diabetic women with poor glucose control morinda, teasel root, Lepidium, achyranthes,
rou cong rong, amla, nu zhen zi, epimedium,
drynaria
• Nutritive herbs
• Oats, green tea, horsetail, dandelion leaf,
nettle, seaweed, spirulina, alfalfa

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Dual Control Model

Inhibitory Excitatory
• Serotonin • Dopamine

• Norepinephrine
• Opioids

• Oxytocin

Libido
• Endocannabinoids
• Melanocortins

• Beta endorphin

• ACTH

• Alpha melanocyte stimulating hormone

• Bartlik, Espinosa, Mindes (ed). Integrative Sexual Health, 2018, Oxford

University Press

Active vs • Highly individual in both men and

Responsive women

Safety Maca and Libido

Comfort
• Shown to improve SSRI-related poor libido in women
Basic
requirements Energy
for decent
interest in sex Time

Basic needs of life are met

• CNS Neurosci Ther. 2008 Fall;14(3):182-91

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Cannabinoids Grandmother Effect

• Research is all over the map

• Much of it is self reported, which is highly subjective

Grandmother Effect

• Having a grandparent in the house lowered rate of depression and • According to church birth and death records in Finland for individuals
deviant behavior (African American homes) born between 1731 and 1890:
• Better behavioral adjustment when grandparents involved (Muslim and • having a maternal grandmother between 50 and 75 years of age while a
Hindu families) grandchild was 5 years old or younger increased the child’s survival
• The effect disappeared for grandmothers older than 75 years of age
• Improvement in breastfeeding and general childhood nutrition (results
• The effect on child longevity was seen mostly with maternal grandmothers
mixed in various studies) and not paternal grandmothers

• Journal of Adolescent Health. 2005;36(3):260–266

• British Journal of Clinical Psychology. 2000;39(2):129–141
• Maternal & Child Nutrition. 2012;8(1):19–35 • DOI:https://doi.org/10.1016/j.cub.2018.12.052

Research is varied

• At the start of the 20th century,

• Multigenerational households tended to have more positive outcomes only 7 percent of older women
for the children lived alone
• Skipped generational households could show negative effect • Peaked at 38 percent in the
• In general, even skipped generational households had more positive 1990s and is now at about 32
effects than single parent households percent
• Lower socioeconomic status led to more stress for the grandmas
• Also occurred if they were stepping in for absent or incarcerated
parents

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In Search

Grandma’s still working

The Goddess

Sacred Sound and Cycles

Creativity Changes

• Georgia O’Keefe
• Frida Kahlo
• Louise Bourgeois
• Mary Cassatt

Our Science shows that connection to Nature is healthy for us

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Questions?

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Physiology basics
Natural
Approaches to
Fertility • Maximum oocytes: 6–7 million (at 20 weeks of gestation)
• 1–2 million oocytes at birthà 300,000–500,000 at pubertyà
Enhancement 25,000 at age 37 yearsà 1,000 at age 51 years
• Fecundity decreases gradually but significantly beginning
approximately at age 32 years; more rapidly after age 37 years
Wendy Warner MD, ABIHM, IFMCP
• Reflects primarily a decrease in egg quality plus a gradual
www.WendyWarnerMD.com increase in the circulating level of FSH and decreases in
@wendywarnermd circulating AMH and inhibin B concentrations

Infertility: Definition
Can our fertility predict
Failure to achieve pregnancy within 12 months of unprotected intercourse in our mortality?
women younger than 35 years or within 6 months in women older than 35 years
• Twin study: 14,000 twins (55% female, 45%
Affects up to 15% of couples male) over 20+ years
• Longer “time to pregnancy” also had the
highest mortality (esp. women)
Offer workup after 6 months to those older than 35 • Women who took 18+ months to conceive had
overall mortality rate 46% higher than those
who conceived in 2 months or less, and were
hospitalized 21% more often
Perhaps sooner if older than 40 or known risk factors in younger women • Think of fertility as a vital sign
(endometriosis, PCOS)
• Hum Reprod. 2021;36 (8):
2309-2320

Preconception Screening
Tests • Review of the medical history
• Physical examination
• Hormones
• Areas of concern
• FSH, LH, Testosterone, Cortisol, DHEA(s), Essential • ovarian reserve
prolactin
components of an • ovulatory function
• Maybe: AMH (antimullerian hormone),
• structural abnormalities
estradiol, progesterone
initial workup
• Thyroid • Imaging
• TSH, free T4, free T3, reverse T3, thyroid
peroxidase abx, thyroglobulin abx, thyroid • tubal patency (hsg or
stimulating immunoglobulin sonoshysterogram)
• Metabolism • pelvic pathology
• CBC, Comprehensive Metabolic Panel,
Hemoglobin A1C, fasting insulin, HS-CRP, • assess ovarian reserve (u/s)
lipid panel with fractionation (particle size)

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• Poor gut health

“Unexplained infertility”: ACOG definition
• Nutritional insufficiencies/
deficiencies
• Toxic exposures
• As many as 30% of infertile couples • Altered immune function
• Luteal phase defect/ low
• Definition of infertility is met
• Basic infertility evaluation is performed
“Unexplained infertility” progesterone

• All the test results are normal

actually consists of : • Thyroid dysfunction
• Oxidative Stress
• At a minimum, these patients should have evidence of: • Inflammation
• ovulation • Energy production/ mitochondrial
• tubal patency function
• normal semen analysis • Adrenal dysfunction
• Chronic infections

“Unexplained infertility”:
• Leads to nutritional deficiency,
leading to poor egg quality or poorly Poor Gut Health Testing
functioning placenta
“Unexplained • Symptoms: • Comprehensive stool testing
infertility”: irregular bowel movements, • Evaluate pancreatic and
constipation/diarrhea, bile/gallbladder function
bloating, excess or foul gas, • Include testing for
Poor gut health belching, halitosis betaglucuronidase
• SIBO test
• History of antibiotic use, H Pylori

Endometrial microbiome

• Varies with the menstrual cycle

“Unexplained • Organic Acids
• Malabsorption, dysbiosis
• Oxidative stress markers
• Lipid peroxidases

• Modulates immune function, impacts implantation infertility”: markers

• Cellular energy,
• 8 OHdG
• Comprehensive Urine
mitochondrial markers
• Higher levels of lactobacillus associated with improved outcomes Elements
• Neurotransmitters • Nutrient elements
• Lactic acid, maintains lower ph in uterus for improved
implantation Testing for metabolites
• Markers of vitamin cofactors • Toxic elements
• Higher levels of gardnerella, prevotella associated with complications Nutritional • Detoxification markers • Omega Check
• Conventional/ national
• Oxalate markers
• Impacted by:
• Gut microbiome
Issues • Amino Acids
labs
• Essential for egg quality
• Essential and nonessential
• Oral microbiome
• Markers of methylation
• Vaginal microbiome pathways
• Contraceptive devices
• Microorganisms on sperm
• Hormones

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“Unexplained infertility”: “U n exp lain e d infe rtility ”:

D e t ox i f i c a t i o n i s s u e s
toxic exposures and altered Te stin g
detoxification

• Take a good history of chemical exposures at • Organic acids

work, home
• Hormone detoxification panels
• Dental history—mercury amalgams, • Mold and mycotoxin testing
caps/implants, dental whitening products
• Microbial organic acids
• Well water or municipal
• Includes beneficial and harmful
• Mold exposure? bacteria, yeast/fungal organisms
• Symptoms • Glyphosate
• Fatigue, brain fog
• Estrogen metabolism testing
• Irregular periods
• Genetic snps
• Poor sleep
• Skin eruptions

“Unexplained infertility”:

• Frequent illness
Altered Immune Function Testing
• Joint pain
“Unexplained
• Myalgia • SED rate
infertility”: • Skin eruptions • hsCRP
Altered Immune • Autoimmunity • Autoimmune panel
Function • Fatigue • ANA, thyroid peroxidase abx,
thyroglobulin abx, thyroid
• Brain fog
stimulating immunoglobulin, DsDNA
• Lyphadenopathy abx, RF, anticardiolipin abx, etc
• cytokines

“Unexplained infertility”: Luteal Phase Dysfunction/ low progesterone “Unexplained infertility”:

luteal phase defect/ low progesterone: Testing

• PMS/ PMDD • Might need no testing at all: work from symptoms alone
• Short cycles • LH>FSH implies poor hormone balance
• Heavier periods • Urine hormone panels
• Poor “stop and start” pattern to bleeding • Adrenal testing (blood, urine, saliva)
• Fatigue, brain fog • Prolactin
• Weight gain
• Breast soreness premenstrually

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• Irregular periods
“Unexplained infertility”:
• Weight gain or loss, unexplained Thyroid Dysfunction Testing
“Unexplained infertility ”: • Crushing fatigue
Thyroid Dysfunction • Agitation
• Palpitations • TSH
• Free T3
• Changes in bowel habits
• Free T4
• Sensation of constant sore throat
• Reverse T3
• Goiter • Thyroid peroxidase antibodies
• Low/suboptimal thyroid function prevents • Thyroglobulin antibodies
appropriate granulosa cell function • Thyroid stimulating immunoglobulin
(increased anovulatory cycles)
• Note:
• Check antibodies even if hormone levels normal
• Thyroglobulin antibodies made once damage to
thyroid has occurred, implies longer course of disease
• All three antibodies can be made at once, so check
them all

“Unexplained infertility ”:
O x i d a t i v e S t re s s

• Weight gain or loss

• Fatigue
• Allergies
• Skin eruptions

• Fatigue
• Allergies
• Skin eruptions
• Joint pain
• Lipid peroxidases “Unexplained infertility ” • Myalgia
• 8 OHdG
• IVF studies: level in follicular
I n f l a m m at i o n • Associated with autoimmunity
fluid is negatively correlated • Leads to other pathways of damage to fertility
with number of eggs retrieved • Elevated BP or swelling
and quality of embryos • Periodontal dz
produced • Bloating/ abdominal pain
• Appears to be elevated in
• Headaches
“Unexplained infertility ”: follicular fluid of those with
• Menstrual cramps, endometriosis
subfertility and endometriosis
• Associated with damage to
Oxidative Stress Testing mitochondria • Testing is similar to immune dysregulation testing

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Inflammation • Insulin resistance Inflammation: • Food triggers

contributes to…. • Luteal phase dysfunction root causes • High glycemic load meals
• Endometrial receptivity • Insulin resistance
• Endometriosis • Underlying infections
• PCOS • Toxins
• Premature ovarian insufficiency • Metabolic endotoxemia/leaky
gut
• Chronic stress

Getting cholesterol to the inner membrane of the

mitochondria is the rate limiting step in hormone production

“Unexplained infertility”: • Fatigue

• Myalgia
Mitochondrial • Mood disorders P450scc
Dysfunction and Energy • Irregular periods
Production • Blood sugar dysregulation Pregnenolone

3βHSD
This implies healthy mitochondria are essential to normal hormone
production!

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“Unexplained infertility”:
Mitochondrial Dysfunction and
Energy Production Testing
• Fatigue
• Myalgia
• Organic acids can imply disruption
• Lactate, pyruvate; plasma amino acids • Mood disorders
• Any hormone imbalance noted on testing “Unexplained infertility”: • Irregular periods
implies disruption
• All hormones made from cholesterol in • Blood sugar dysregulation
the mitochondria
• Blood sugar regulation Adrenal Dysfunction • Poor sleep
• Altered circadian rhythm due to
• Fasting glucose choice or work
• Fasting insulin
• Hemoglobin A1C
• Make sure the A1C and fasting
glucose “match”
• HOMA-IR

“Unexplained infertility”:
Chronic stress chronic stress testing
• Stress induced levels of glucocorticoids in the ovary impair egg cell
Chronic Infection Testing
• Salivary cortisol
function • (with cortisol awakening response)
• IVF studies: • Urine DHEA(s)
• Fluid from follicles containing eggs that did not fertilize had levels of cortisol • If doing serum, get cortisol am and
significantly higher than in the fluid from follicles containing successfully DHEA am
fertilized egg cells • Must be drawn fasting and prior to
9am. No gym first!
• Will give you a snapshot of which
phase of adrenal dysfunction they
are in
• Serum cortisol can be misleading if
they are scared of blood draw!

“Unexplained infertility”:
Fatigue chronic infections testing
Myalgia

“Unexplained infertility”: Joint pain • A bigger problem for male infertility

• Reliable Lyme panel
Mood disorders • Additional testing for co-
Chronic Infections infections
• Vaginal / cervical PCR
Frequent illnesses • Chlamydia
• Gonorrhea
Chronic/ subacute vaginitis • Atopobium, guardnerella
• Specialty vaginal microbiome

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• 90% from low sperm count or quality

• Anatomic abnormalities
• Bilateral obstruction of the vas deferens
Miscellaneous: • Epididymitis
homocysteine • Varicocele
• Retrograde ejaculation
• Endocrine issues
• Elevated homocysteine increases chance of
neural tube defect
Specific to • Congenital GnRH Deficiency (Kallmann syndrome)
• Hemachromatosis
• Impairs growth and function of blood vessels in
the placenta
Men • Head trauma
• Intracranial radiation
• IUGR, preeclampsia • Testosterone supplementation
• Impacts sperm: causes oxidative stress, • Hyperthyroidism
decreasing sperm motility and depleting • Toxins
antioxidants in seminal fluid • Insecticides, fungicides, pesticides, smoking, excess
• Check methylation status (blood test) alcohol, Agent Orange
• Cannabis

Gut Health

Treatment • Demulcents

Suggestions • Soothe mucosal lining

• Marshmallow, slippery elm, aloe
• Carminatives
• Stimulate bile production
• Improve peristalsis
• Fennel, chamomile, ginger,
peppermint, wild yam
• Fermented foods
• Pre- and Probiotic foods
• If SIBO, antibiotics

Beta Glucuronidase

• Induced by abnormal microbiome

• Typically with a history of constipation
©2023 The Institute for Functional Medicine

• Reactivates estrogen breakdown products

• Ovaries don’t know this is going on, so not increasing progesterone to
compensate!

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Carotenoids: Reduce Serum B-glucuronidase Activity Other B-Glucuronidase Inhibitors

Alpha-carotene: Beta-carotene:
• Pumpkin (highest) • Sweet potato (highest)
• Silymarin (milk thistle extract)
• Carrot • Kale
• Winter squash • Carrot • Reishi (ganoderma lucidum)
• Red peppers • Turnip • Licorice (glycyrrhizin)
• Collards • mustard greens
• Dandelion greens • Spinach • Lactic acid probiotics: lactobacillus acidophilus, L. rhamnosus GG,
• Spinach • Butternut squash Bifidobacteria
• Turnip greens • Herbs: basil, parsley, marjoram, oregano, • Prebiotics: inulin
• Cantaloupe sage, coriander, thyme
• Cilantro • Lettuce: Romaine, green leaf • Caloric restriction
• Thyme • Collard greens • Lacto-vegetarian diets reduces the level
• Romaine lettuce • Red hot chili peppers
• Tomato • Dandelion greens
• Swiss chard • Pumpkin Plant Med 2000;66(1):40-3. Arch Pharm Res
2005;28(3):325-9. Cancer Lett 1990;54:1-8
• Apple
• Avocado

Nutrition for Ovarian Aging

Iron
• Vitamin C and E—antioxidants
• Improves oxygen delivery to
• Animal studies: reduces aging effects on ovarian reserve and improves egg
uterus and ovaries quality
• Improves egg quality • NAC—reduces oxidative stress
• Improves egg quality, embryonic development
• Required by granulosa cells • Improves cervical fluid
(which support follicles)
• Curcumin/turmeric
• Improves endometrial lining • Increases number healthy follicles
• Dandelion, nettle, yellow dock, • Improves ovarian blood flow
• Protects ovarian reserve
parsley, amaranth
• CoQ10—antioxidant, mitochondrial support
• Quercetin—antioxidant, slows follicular atresia

Nutritional Issues Pomegranate

• Vitamin C, polyphenols, phytoestrogens

• Look for unspoken • Anti-inflammatory, enhances endometrial thickness
disordered eating patterns
• Is it financial? • Improves implantation (rat study)
• www.leannebrown.com • Biomedical and Pharmacology Journal, 2015, 8(2), 971–977
Free downloadable book:
“Good and Cheap”

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Improving Mitochondrial Function

Vitex for hormone balance

• Improve blood sugar stability • Specific nutrients • Flavonoids increase the release of nitric oxide (NO) and cyclic guanosine
• Coq10 monophosphate (cGMP) from vascular endothelium to increase endometrial
• Regular moderate exercise blood flow
• Resveratrol
• Avoid toxins • Alpha Lipoic Acid • Isoflavones reduce the release of the prolactin and FSH hormones by affecting
• Deal with inflammation • N-acetylcysteine the HPG axis
• Sleep • L carnitine • Improves progesterone production
• Melatonin
• Curcumin/ Turmeric • African Journal of Traditional, Complementary and Alternative Medicines,2012, 9(4), 584–590 .
• Green tea / EGCG

Nigella sativa for hormone balance

• Acupuncture
• Nitrous Oxide production
• Long-term use of N. sativa can reduce testosterone levels, exerting a negative • Beets
feedback on LH.
• May reduce LH dominance over FSH by inhibiting nitric oxide and leptin-releasing
Optimal pelvic • Garlic
• Leafy greens
neurons that are directly involved in the synthesis of LH from the anterior blood flow • Pomegranate
pituitary gland • Watermelon
• Mouse study • Massage/manual therapy, exercise, reflexology
• International Journal of Reproductive BioMedicine, 2020,18(9), 733.
• Hydration

Inflammation
modulators Chronic Stress
• Omega three fatty acids • Adaptogens
• Turmeric/curcumin
• Nervines
• Bromelain
• Meditation
• Quercetin
• Specialized pro-resolving mediators (SPMs) • Mindfulness practices
• Resveratrol • Heart rhythm variability manipulation
• (and a host of plants!)

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Ashwaganda (Withania somnifera) Maca (Lepidium peruvianum)

• Increased gonadotropin release and improved oogenesis • Member of the Brassica family
• Action on HPAG axis, improved estrogen balance • Action directly on HPAO axis
• Via GABA mimetic properties • Contains glucosinolates
• (mouse study) • Modulates estradiol, progesterone, FSH, ACTH
• Phytotherapy Research, 2010, 24(8), 1147–1150
• Front Pharmacol. 2024 Feb 19;15:1360422.

• Calming
Meditation
• Improve sleep
• Improve adrenal function indirectly
• Examples
• Lavender
• Regulates HPAG axis
Nervines • Chamomile
• Lemon balm • Improves sleep
• Passionflower • Increases pregnancy rates for IVF
• Milky oats (Avena sativa) cycles
• Skullcap
• Catnip

Behav Res Ther. 2016 Feb;77:96-104.

Heart Rhythm Variability

DHEA
Manipulation • Enhances mitochondrial energy production
• Improves egg maturation
• Decreased HRV is indicator for poor IVF
outcome • May slow follicular aging in low ovarian reserve
• HRV can be directly improved by • Lowers chance of aneuploidy so fewer pregnancy losses
focused shift in emotional regulation • IVF: higher quality embryos, improved pregnancy rates
• Research from the Institute for
Heartmath
• 25-75 mg daily (often need less to get into optimum range)

• Reprod Biol Endocrinol. 2011 May 17;9:67.

• PLoS One. 2018 Mar 12;13(3):e0193899. doi:

10.1371/journal.pone.0193899

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Thyroid function
• Adjust thyroid meds as needed for optimal range • Decreased by melatonin
• + antibodies with normal function: work to modulate immune function
supplementation
• Don’t start thyroid meds right away
• Selenium, D, myoinositol High 8-OHdg • 3 mg oral cycle day 5-midcycle or
• Immune amphoteric herbs (eg: licorice, tulsi, turmeric) lower dose (0.3mg) daily
• Mushrooms
• Reishi
• Shitake
• maitake

High Toxic Load

Melatonin
• Decrease exposure (personal care products, cleaners, work, dental) • Downregulates HPA Axis
• Decreases aromatase expression and activity
• Hydration
• Therefore decreases circulating estrogens
• Daily bowel movements
• Decreases 17 beta dehydrogenase (decreases androgen production)
• Regular sweating
• Increases activity of sulfotransferase
• Cruciferous veggies and phytonutrients to support liver detox pathways
• Much on the market is synthetic; look for a good plant based source
• Alterative Herbs
• Violet
• Burdock • Curr Cancer Drug Targets. 2008 Dec;8(8):691-702
• Cleavers
• Nettles

Melatonin, continued
• Acupuncture improves sperm quantity and motility
•
•
Increases follicular growth rate
Improves oocyte quality
Treatment • Saffron improved motility
• Ashwagandha improved pregnancy rate
• Increases number of quality embyros with IVF Specific to • Nutrients: zinc, vitamin C, vitamin E, co q 10
• Enhances the repair of double-strand breaks via the non-homologous end joining (NHEJ) pathway
to protect oocytes from the accumulation of DNA damage during prophase arrest Men
• Protects the ovaries from chemotherapy induced damage, (mouse study)
• Inhibits ovarian granulosa cell apoptosis and maintains anti-Müllerian hormone (AMH) expression • Health Sci Rep. 2024
(mouse study) Jun 24;7(6):e2118.

• Antioxidants 2023, 12, 1601. https://doi.org/10.3390/antiox12081601 (this is a great review paper!)

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• Specific genetic nutritional markers

• Methylation
• Vitamin B12 transport
Bao Mai
• Melatonin receptor
• Insulin secretion • TCM: Channel that connects heart to uterus
• Vitamin D metabolism
• Translates as “Uterus Vessel”
• Targeted nutrition and lifestyle interventions based on
GrowBaby Health results • When heart qi does not descend to the uterus, causes infertility and amenorrhea
• Working with 50% Medicaid population for their study • When emotions not processed properly, qi and blood flow changes and menstrual
• Midstudy results (N=16) NNT = 10.3 irregularities arise
(growbabyhealth.com)
• Preterm births 0%
• SGA 0%
• Preclampsia 0% • Worry à anovulation (heart blood and/or yin deficiency, heart qi stagnation)
• GDM 6% • Overwork à amenorrhea (heart yin deficiency, heart Qi stagnation or rebellious
• LGA 12% heart Qi)
• c/section birth 12%
• Sadness à menorrhaghia (heart yin deficiency with floating yang or Qi stagnation)
• Estimated savings $650K

Things to discuss with every woman of reproductive

age considering pregnancy
• Stop smoking • Start a prenatal vitamin
• Stop alcohol • Get a pelvic exam and pap
• Move daily • Get a full medical evaluation/ labs Thanks for your
• Clean up diet
• Limit/ stop sushi, tartare
• Start discussing any age-related attention
factors (genetic testing)
• Get off antacids/ PPI’s
• Discuss personal preferences of
• Get restful sleep
risks they are willing to incur re:
• Improve gut health place of delivery
• Stop/limit hair treatments/
color • Discuss what life will be like with a
baby

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Last “Butt” Not Least:

Herbal/Nutritional Proctology
David Winston, RH(AHG) ©2025

Proctology is the branch of medicine that treats diseases and problems of the anus, rectum and large
intestine. Common conditions that proctologists (colorectal surgeons) treat include hemorrhoids, anal
fissures, Crohn’s disease, colon polyps, colorectal cancer, constipation, rectal prolapse, diverticulitis,
rectal spasms, ulcerative colitis, fibrosing proctitis, and IBS (gastroenterologists also often treat
Crohn’s disease, diverticulitis, ulcerative colitis and IBS). In this paper we will focus on diseases/
conditions of the rectum and anus and for more information on IBS, IBD, diverticulitis or constipation
I would refer readers to my paper on Herbal/Nutritional Gastroenterology (Winston, 2024).
The rectum and anus are the most distal part of the large intestine. The rectum is a muscular tube that
measures 5-6” long and acts as a repository for stool from the colon. When the rectum is full it triggers
nerves that cause an urge to have a bowel movement. The anus is the opening at the end of the rectum
that has two sphincters (internal and external anal sphincters) that keep stool in the colon until it is time
to defecate.

Hemorrhoids

What are hemorrhoids and what causes them?

When the venous drainage of the anus is impaired, the resulting anal/rectal venous congestion can
cause swelling of the anal mucosa and hemorrhoids. Studies suggest that in chronic hemorrhoidal
disease there is decreased Fibulin 3 and 5, which are elastic proteins that are essential for healthy anal
cushion connective tissue (Zhou, et al, 2023). In addition, there are elevated matrix metalloproteinase
(MMP) levels. MMPs play an important role in extracellular matrix degradation. Elevated levels of
these proteins interfere with normal, reparative and remodeling processes in the anal canal (Zhou, et al,
2023). Hemorrhoidal tissue also has increased levels of endothelial nitric oxide synthase (eNOS) and
nitric oxide, which results in vascular dilation and varicosities, elevated VEGF and VEGFR2, which
promote increased angiogenesis, local mast cell activation and higher levels of pro-inflammatory
compounds such as COX-2, TNF-α, IL-6, IL-8, IL-1β and IFN-γ (Zhou, et al, 2023). In humans the
anus is approximately 4cm long and midway between each end is the dentate line. Hemorrhoids that
develop above (proximately) the midpoint are “internal hemorrhoids” and those below (distal) are
external hemorrhoids. Internal hemorrhoids are painless, as they have few nerve endings, but can
bleed, while external hemorrhoids can cause itching, bleeding and anal pain. The exact etiology of
hemorrhoids is poorly understood but causative factors include constipation with straining, pregnancy,
prolonged sitting, regular heavy lifting, obesity, chronic diarrhea, chronic coughing (which increases
intra-abdominal pressure), anal sex, pelvic floor dysfunction with the displacement of anal cushions,
poor vascular integrity, cirrhosis with ascites and a low fiber diet. Many hemorrhoids are
asymptomatic, so the frequency is unclear.

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In a study of patients undergoing colonoscopy 38% were found to have hemorrhoids, but of those 55%
reported no symptoms (Riss, et al, 2012). People between the ages of 45-65 years old have the highest
prevalence of hemorrhoids.

Orthodox treatment of hemorrhoids initially involves “conservative treatment” with a high-fiber diet
(25-35g/day), fiber supplements, stool softeners, increased water intake and sitz baths. Topical (rectal)
analgesics (such as nifedipine) may also be prescribed. If this treatment is not effective, then office-
based surgical procedures such as rubber band ligation or infrared photocoagulation are commonly
recommended. The rubber band ligation has been shown to have better long-term success, while the
infra-red photocoagulation offers quicker pain relief (Mott, et al, 2018). For severe hemorrhoids
(Grade III or IV), a hemorrhoidectomy surgery is used. This procedure often causes significant post-
surgical pain, a longer recovery period and the possibility of post-surgical complications.
Another technique is Ligasuretm which uses diathermy, reduces blood loss and post-operative pain
(Nienhuijs & de Hingh, 2009).

Herbal Treatment of Hemorrhoids

The herbal treatment of hemorrhoids has several components. First it is essential to identify the
underlying issues causing the hemorrhoids. Constipation is a likely culprit, relieving constipation and
softening the stool is a first step.

Relieve constipation – using soluble fiber (psyllium seed, flax seed, chia seed, sterculia), prune juice,
magnesium oxide/citrate, bitters, aperients, Triphala, kiwi fruit. To soften the stool herbs such as
Slippery Elm, Marshmallow and Butternut bark can be effective.

Secondly, it is important to enhance vascular integrity and inhibit inflammation using flavonoid-rich
herbs/foods such as Amla, Hawthorn, Blueberry, Rose Hips, Goji Berry, Rosemary, Green Tea, etc.

In addition, relieving pelvic congestion using sitz baths, squatting and herbs such as Horse Chestnut,
Ocotillo and Butcher’s Broom are an important part of the treatment protocol.

If there is bleeding due to hemorrhoids the following herbs can be used topically and orally to help
control it – Tienqi Ginseng, Yarrow, Shepherd’s Purse, Witch Hazel.

Specific Herbs and Supplements for Hemorrhoids

Alpha lipoic acid (ALA) – in a preliminary RCT, patients with stage II or III hemorrhoids were given
either ALA (200 mg/day) or no treatment for 12 weeks. After the completion of the study, participants
taking the supplement had significant reductions in hemorrhoid pain, itching and bleeding, as well as
reduced inflammatory markers, such as C-reactive protein and total leucocytes (Sabonovic, et al,
2019).
Dose: 200mg BID

Aromatic Collinsonia leaf, flower, root (Collinsonia canadensis) – was used by the Eclectic
physicians for tissue that has lost tonicity with engorgement or edema. It is used to treat BPH, mild
mitral valve prolapse, allergic rhinitis, varicose veins and hemorrhoids. It is most effective for
hemorrhoids of a recent origin (1 year or less). It can be combined with Horse Chestnut or Ocotillo.
The most effective preparation is a fresh tincture of the leaf, flower, stem and root known as Aromatic
Collinsonia. Collinsonia is very drying and can worsen constipation, so use small amounts in a larger
formula and include yin tonics.

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Tea: 1 tsp. dried root/herb, 10 oz. water, decoct 15 minutes, steep covered for 40 minutes take 2-4 oz.
3x/day (the tincture is far better than the tea).
Tincture (1:2): .5-1 mL TID/QID

Box Elder twigs (Acer negundo) – while I have no experience using the Box Elder twigs, I found an
account of their use in the Eclectic Medical Journal. The physician who wrote the report used a
tincture made of the dried green twigs. He stated he had used them repeatedly for treating hemorrhoids
and found this preparation superior to Collinsonia or Horse Chestnut.
Tincture (1:5): 1-2 mL TID

Butcher’s Broom rhizome (Ruscus aculeatus) – is a European herb used to strengthen the
vasculature. It is often used in formulas for treating varicose veins, chronic venous insufficiency and
spider veins. It works as an alpha-adrenergic agonist increasing vasoconstriction and improving
endothelial function and peripheral vascular function. It can be combined with Horse Chestnut,
Collinsonia or Figwort for treating hemorrhoids. Avoid use in people with hypertension.
Tincture (1:5 or 1:4): 2-3 mL (40-60 gtt) BID/TID
Standardized extract (10-15% saponins): 100 mg twice per day
Proprietary extracts: 1 capsule or tablet BID

Chebulic Myrobalan (Terminalia chebula) – is one of the 3 ingredients in the classic Ayurvedic
formula Triphala. It has been used as a stand-alone remedy for treating hemorrhoids in traditional
Persian medicine (TPM). In a RDBPC trial, patients with hemorrhoids were given the herb or a
placebo in capsules for four weeks. The patients receiving the Chebulic myrobalan had significant
reductions in pain and hemorrhoid size, as well as reduced constipation compared to the placebo group
(Andarkhor, et al, 2019).
Tea (Infusion): 1 tsp. dried, powdered fruits, 8 oz. hot water, steep 15-20 minutes, take 4 oz. TID
Tincture (1:5), 30% ETOH, 10% Vegetable Glycerin (rarely used as a tincture)

Fiber supplements – fiber supplements act as bulk laxatives and can help prevent or enhance
treatment of hemorrhoids by relieving one of the underlying causes – constipation with straining.
Multiple studies show that taking Psyllium daily helped reduce hemorrhoidal bleeding, hemorrhoidal
congestion and the need for hemorrhoid surgery (Garg, et al, 2017; Murshid, 1997, Perez-Miranda, et
al, 1996).

Figwort leaf or root (Scrophularia marilandica) – in old English, a “fig” was a slang term for large,
red, bleeding hemorrhoids, while wort meant plant, so the name Figwort means large, red, hemorrhoid
plant. The herb is often combined with Collinsonia, Horse Chestnut, Wintergreen or Witch Hazel to
treat large, painful or bleeding hemorrhoids.
Tea (Infusion): 1 tsp. dried herb, 8 oz. hot water, steep for 1 hour, take 4 oz. 3-4x/day
Tea (Decoction): 1 tsp. dried root, 10 oz. water, decoct 10-15 minutes, steep 40 minutes, 4 oz. TID
Tincture (1:5): 1- 2 mL (20-40 gtt.) TID/QID

Flavonoid-rich supplements – numerous supplements high in flavonoids have been shown to reduce
hemorrhoidal symptoms by improving vascular integrity, pelvic circulation and reducing inflammation.
Pycnogenol® has been shown in clinical trials to reduce 3rd and 4th degree post-partum hemorrhoid
symptoms compared to orthodox treatment (Belcaro, et al, 2014) and acute hemorrhoid flares when
used orally and topically (Belacaro, et al, 2010). A flavonoid mixture (diosmin, troxerutin, rutin,
hesperidin and quercetin) reduced hemorrhoidal symptoms and bleeding after 1 and 6 months (Corsale,
et al 2018) and a combination of micronized flavonoids, mixed with vitamin C, Gotu Kola, Bilberry
and grape seed extract was given to patients with stage I or II hemorrhoids for one week. After this
short treatment 89.8% of the treatment group had a reduction of hemorrhoid severity by at least 1 grade
(Gravina, et al 2021).

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Gotu Kola (Centella asiatica) – is used orally and topically for tissue that is red, hot or inflamed. In
addition to its anti-inflammatory activity, it also enhances circulation. It has been used to treat
hemorrhoids, varicose veins and decubitus ulcers. In a RCT, Centella was superior to conventional
treatment of patients who had undergone a hemorrhoidectomy, reducing bleeding, pain and speeding
healing (Chiaretti, et al, 2021).
Tea (Infusion): 1-2 tsp. dried herb, 8 oz. hot water, steep covered 45 minutes, take 4 oz. 3x/day
Tincture (1:2): 1.5-2 mL (30-40 gtt.) TID

Gum Guggul (Commiphora mukul) – in Unani-Tibb medicine, this gum resin is used to treat
hemorrhoids. In a RCT, patients with 1st-2nd degree hemorrhoids and constipation were given Gum
Guggul resin, 3 g/day (dose form unstated) or standard treatment of lactulose and an anti-hemorrhoidal
suppository for 4 weeks. The patients receiving the herb had more significant reductions in
constipation, hemorrhoid size, rectal pain, flatulence and dyspepsia (Yousefi, et al, 2013).
Tea (Decoction): 1 tsp. powdered dried resin, 10 oz. water, decoct 20 minutes, steep covered 1 hour,
take 4 oz. 3x/day
Tincture (1:4 or 1:5): 1-2 mL (20-40 gtt) TID
Capsules (standardized to Guggalsterones): 100-500 mg TID

Horse Chestnut fruits (Aesculus hippocastanum) – is used in Europe to strengthen and tonify veins,
capillaries and arteries. It enhances peripheral circulation and relieves venous stasis that can cause
varicose veins and hemorrhoids. I use it in small amounts along with Collinsonia, Figwort or Witch
Hazel to treat recent or chronic hemorrhoids. In Europe, extracts from Horse Chestnut (Aescin/escin)
are used topically to treat hemorrhoids as well.
Tincture (1:2): .25-.75 mL (5-15 gtt.) TID
Capsules: A standardized product (16-20% Escin) has been used in several studies with a dose of 300
mg of the extract every 12 hours.

Ocotillo stem bark (Fouquieria splendens) – is a Southwestern plant used to treat pelvic stagnation.
It can be used as part of a formula for pelvic fullness syndrome, uterine fibroids, portal hypertension,
BPH or hemorrhoids. As a treatment for hemorrhoids, it works best in people with a constant sense of
pelvic fullness, a feeling like you are sitting on a ball, or enlargement of the pelvic lymph nodes.
Tincture (1:2): 1.5-2.5 mL (30-50 gtt.) TID/QID

Wintergreen leaf (Gaultheria procumbens) – has analgesic, anti-inflammatory, astringent and

diuretic effects. It is useful for urinary tract infections, bacterial prostatitis or GU inflammation with
dull, aching pain. The Eclectic physicians also used it for treating large, purple painful hemorrhoids
caused by impaired pelvic circulation or constipation, with sacral or lumbar pain. It can be combined
with Ocotillo, Figwort and Horse Chestnut.
Tea (Infusion): 2-3 tsp. dried leaf, 8 oz. hot water, steep covered for 40 minutes, take 2-3 cups/day
Tincture (1:2): 1.5-2 mL (30-40 gtt.) TID-QID

Witch Hazel bark or leaf (Hamamelis virginiana) – is commonly used topically to treat
hemorrhoids. The tincture can also be used internally, and is used along with Horse Chestnut, Amla,
Hawthorn or Goji berry to tonify veins, capillaries or arteries. A combination of Hamamelis,
Collinsonia and Horse Chestnut can offer significant benefits for hemorrhoids of a recent origin.
Tea (Infusion): 1/2 tsp. recently powdered dried bark*, 8 oz. hot water, steep covered for 40 minutes,
take 4 oz. 3x/day
Tincture (1:2 or 1:5): 1-2 mL (20-40 gtt.) TID/QID

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Topical Applications for Hemorrhoids (as well as for anal fissures)

Many herbs can be used in sitz baths, ointments or suppositories to relieve hemorrhoidal pain, itching,
bleeding and to shrink engorged tissue. As mentioned in the materia medica for hemorrhoids,
Pycnogenol®, Gotu Kola, Horse Chestnut and Witch Hazel are commonly used topically as well as
orally. Other local applications that have been shown to help alleviate and speed healing of
hemorrhoids include Myrtle (Myrtus communis) cream (Malekuti, et al, 2019), Eggplant cream
(Donmez, et al, 2020), Leek cream (Mosavat, et al, 2015) and Yarrow cream (Mahmoudi, et al, 2023).
In a RDBPC a proprietary cream made from Leeks, Gum Guggul, and Sesame oil was found to reduce
anal irritation, bleeding, and pain in people with hemorrhoids (Mehdi, et al, 2021). Rudolf Weiss, MD,
felt that cool, wet compresses made from Arnica tincture (1-2 tsp. per ½ liter of water) was highly
effective for acute hemorrhoidal inflammation. He also used Oak bark decoction or a Chamomile
infusion as compresses. This was followed up with a Witch Hazel ointment (Weiss, 2001). In the
1970’s I learned an interesting treatment for hemorrhoids from William LeSassier:

Potato (Solanum tuberosum) – the common potato can actually be of significant benefit for treating
internal hemorrhoids. A small piece (the size of the last 2 joints of your little finger) of the raw potato
is inserted into the rectum before bedtime and then excreted when you defecate the next day. The
potato suppository helps reduce irritation, swelling and bleeding.

Most rectal suppositories are made in a cocoa butter base (solid when refrigerated, but it melts at body
temperature). Many other vulnerary, anti-inflammatory, astringent or analgesic herbs can be added to
the cocoa butter base, including Calendula, Plantain leaf, Aloe gel, Chickweed, St. John’s wort,
Comfrey leaf or Turmeric, and a few drops of Lavender EO can also be beneficial.

Exercises for Hemorrhoids

Butt-ups are an exercise that was taught to me by Dr. Daniel Jass, MD, a former student of mine and
an excellent family practice physician. Get ready for bed, take care of everything you need to do so
that once you get into bed, you can stay there. Place 3 regular pillows on the bed where your pelvis
will rest. Lay face down with your pelvis on the pillows, your face and feet will be touching the bed,
and your pelvic region will be elevated. Stay in this position for 10 minutes. When the time is up, roll
over, rearrange the pillows without sitting up and read, or go to sleep. This drains the pelvic region
and then for 7-8 hours gravity is not pooling blood in the anal mucosa and veins. This should be done
every night, and I have had patients report back that over several weeks long standing hemorrhoids
have shrunk and, in many cases, disappeared. Continue this once they have resolved as a preventative
therapy, it works!

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Post-Operative Rectal/Anal Pain

There are situations where herbal or orthodox conservative treatment is ineffective, and a patient needs
anorectal surgery for severe hemorrhoids, anal fissures, anal fistulas or perianal abscesses. Studies
show that 65% of these patients experience moderate to severe pain after anorectal surgery (Li, et al,
2023). In a meta-analysis of RCTs of people undergoing anorectal surgery, TCM practices including
acupuncture, sitz baths, anal fumigation (steaming) and the use of herbs were shown to help speed
healing, and reduce pain and opioid use (Li, et al, 2023). Even simple warm water sitz baths have been
found to help relieve post-hemorrhoidectomy pain (Liao, et al, 2024). Medicated sitz baths using 2
formulas (Qingre Zoshi Zhi Tong* immediately after surgery and then switching to Yiqi FuZhang **
after the early healing stage) significantly improved wound healing, pain and edema in patients after
anal fistula surgery (Du, et al, 2022). A medical fumigation using a Chinese formula, Hu Huang Burn
Liniment, was shown to significantly reduce inflammatory markers (MMP-9, IL-10), speed healing,
reduce pain, edema and exudates after hemorrhoidal surgery (Sha, et al, 2022). This product contains
Safflower, borneol, Senecio, Du Huo, water Buffalo horn, Huang Bai, Huang Qin and Japanese
Knotweed.
________
*Qingre Zaoshi Zhi Tong contains 20 g. Chinese Coptis, 20 g. Phellondendron, 12 g. Gentiana macrophylla, 12 g
Atractylodes chinensis, 20 g Talc, 30 g. Sophora, 15 g. White Peony and 6 g. Licorice. This formula clears damp heat,
drains dampness and removes toxins.

**Yiqi FuZhang contains 30 g. Sophora, 15 g. White Peony, 6 g. Licorice and 15 g. Sepiella/Cuttlefish, which promotes
healing, the elimination of pus and toxins and improves circulation.

Rectal Spasms
Acute Rectal Spasms (proctalgia fugax) – can be very uncomfortable, they can occur without
warning, cause intense rectal pain, occasionally loss of bowel control and last from seconds to minutes.
The spasm is caused by cramping of the pelvic floor muscles, anal sphincter muscles or rectal muscles.
A more chronic condition, Levator syndrome (Levator ani syndrome), can last for several days at a
time and is felt higher in the pelvis than proctalgia fugax.

The cause of either condition is unknown but chronic stress is seen as a predisposing factor. Other
triggers for rectal spams include orgasm, constipation with straining, excessive peristalsis and menses.
Another potential underlying factor is magnesium deficiency. In several studies, up to 68% of
Americans do not get adequate magnesium or are magnesium deficient (Workinger, et al, 2018; King,
et al, 2005). Diagnosing hypomagnesia is difficult, as serum magnesium levels do not reflect tissue
levels. Symptoms of hypomagnesia can include muscle spasms (including rectal spasms), bruxism,
hypertension, anxiety, venospasm, torticollis, bladder spasms, cardiac arrythmias and menstrual
cramps.

Herbs and Supplements for Rectal Spasms

Cyperus tuber/Xiang Fu (Cyperus rotundus) – is used in TCM for pain and spasm in the stomach,
large intestine, small intestine, rectum, uterus, bladder or testes. It combines well with Horse Chestnut,
Kava, Kudzu or Silk Tassel.
Tea: 1 tsp. powdered, dried tubers, 8 oz. water, decoct 10-15 minutes, steep covered 1 hour, take 2
cups/day
Tincture (1:5), 50-60% ETOH Dose: 2-3 mL (40-60 gtt.) TID/QID
Extract granules (5:1): 1 g., once per day mixed in water

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Horse Chestnut seeds (Aesculus hippocastanum) – have analgesic, anti-inflammatory,

antispasmodic and circulatory enhancing activity. It is commonly used to treat hemorrhoids, rectal
irritation, proctitis and rectal spasms. For rectal spasms I frequently combine it with Cyperus,
Platycodon or Kava.
Tincture (1:2), 60% ETOH Dose: .25-.75 mL (5-15 gtt.) TID
Capsules: A standardized product (16-20% Escin) has been used in several studies with a dose of 300
mg. of the extract every 12 hours.

Kava root (Piper methysticum) – has significant antispasmodic activity and can help relieve rectal,
bladder or vaginal (vaginismus) spasms. I use it with Horse Chestnut, Cyperus and Wild Yam.
Tea: 1-2 tsp. dried, powdered root, 8 oz. water, decoct 15 minutes, homogenize it in a blender, and
steep 1 hour. To enhance absorption and flavor, mix it with coconut milk and pineapple juice. Take 4
oz. 4x/day
Tincture (1:4 or 1:5): 2-4 mL (40-80 gtt.) TID/QID
Capsules: Standardized to 60 mg. Kavalactones - 2-4/day

Kudzu root/Ge Gen (Pueraria montana var. lobata) – Kudzu has significant antispasmodic activity
and in TCM, the combination of Kudzu, Cyperus and Platycodon is commonly used to help relieve
rectal and intestinal spasms.
Tea (Decoction): 1-2 tsp. dried root, 12 oz. water, decoct 15-20 minutes, steep 1 hour, take 2-3
cups/day
Tincture (1:5): 3-5 mL (60-100 gtt.) TID/QID
Extract granules (5:1): 2 g., 1-2 times per day mixed in water
Capsules: 5:1 extract 1-2 500 mg. capsules TID

Magnesium – as mentioned previously, hypomagnesia may be a cause of proctalgia fugax, and taking
a bioavailable form of magnesium can, over time, reduce or prevent these painful spasms. I prefer
magnesium bisglycinate as an absorbable form of the mineral.
Dose: 250 mg BID

Platycodon root/Jie Geng (Platycodon grandiflorus) – is commonly used in TCM for

respiratory conditions. In Chinese medicine the organs are paired, and the lungs and large intestine
have an affinity embryologically. So not only can Jie Geng be used for lung heat and wind (spasms)
patterns, it can also be part of a formula for IBS, and rectal spasms. I combine it with Kava, Kudzu,
Cyperus or Horse Chestnut.
Tea: 1 tsp. dried root, 10 oz. water, decoct 10-15 minutes, steep 45 minutes, take 4 oz. 3x/day
Tincture (1:5), 50-60% ETOH Dose: 2-3 mL (40-60 gtt.) TID
Extract granules (5:1): 1 g., 1-2 times per day mixed in water

Silk Tassel leaf (Garrya wrightii, G. fremonti, G. flavescens, G. elliptica) – has analgesic and
antispasmodic activity. It is an anticholinergic which helps to relax smooth muscle tissue, including
the rectum. It is far safer than many other anticholinergics like Datura, Henbane or Belladonna. It can
be used for spasmodic diarrhea, gallbladder spasms, flatulent colic and rectal spasms, along with Kava,
Kudzu, Wild Yam or Horse Chestnut.
Tea (leaves): 1 tsp. dried leaves, 8 oz. hot water, steep 20-30 minutes, take 2 oz. up to 5 times per day
Tincture (1:2 or 1:5: Leaf - 1-2 mL up to 5 times per day, Root - 10-15 gtt. up to 5 times per day

Wild Yam rhizome (Dioscorea villosa) – is mistakenly thought of as a “woman’s herb”. While it
does contain the steroid diosgenin, diosgenin cannot be converted in humans into any functional
hormones. The specific indications for Dioscorea are intestinal and hepatic/biliary colic. It not only
relieves flatulent colic, it reduces intestinal, rectal, gallbladder and uterine spasms.
Tea: 1-2 tsp. dried c/s root, 12 oz. water, decoct 15-20 minutes, steep for 1 hour, take 2-3 cups/day
Tincture (1:5 or 1:2): 1.5-2 mL (30-40 gtt.) TID/QID
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Fecal Incontinence
In TCM a leaky jing gate can cause urinary or fecal incontinence. This inability to control bowel
movements is embarrassing, can make people isolate and contribute to a severely decreased quality of
life. There are many causes of this issue, including birth defects, acute or chronic diarrhea, spinal
injuries, Crohn’s disease, ulcerative colitis, gastric ulcers with bleeding, large internal hemorrhoids
(which can prevent the anal sphincters from properly closing), diabetes, MS, long-term chronic
constipation, rectal prolapse or a rectocele. Risk factors that can promote the development of this
condition include old age, having been pregnant and dementia.

Treating fecal incontinence depends on the underlying cause. Damage to the rectal muscles from
surgery, birth defects, trauma and nerve damage from surgery or disease (MS, diabetes, Parkinson’s
disease, stroke, dementia) may not readily respond to treatment.
Herbs that enhance nerve regeneration (such as St. John’s wort, Prickly Ash, Gotu Kola and Red
Ginseng) may offer modest benefits. If the underlying issue is constipation or diarrhea, treating the
cause is necessary (see Winston, 2024). In TCM a leaky jing gate is treated with astringing tonics such
as Schisandra, Shan Zhu Yu/Chinese Dogwood fruit, Psoralea seed, Eurayle seed and Chinese Rose
hips. In India, the Ayurvedic formula Triphala, with 2 parts Amla to 1 part Chebulic and Beleric
myrobalans is often used. Other herbs that can be useful for a leaky jing gate include Agrimony, Wild
Geranium, Witch Hazel and Indian Madder root.

Western herbs such as Marshmallow and Slippery Elm can help both constipation and diarrhea. If
flatulence with stool leakage occurs using carminatives (Ginger, Cardamom, Cinnamon, Sage, etc.),
bitters and digestive enzymes can reduce gas production.

Exercises to reduce fecal incontinence include pelvic floor training (Kegal exercise) and yoga (bridge
pose, squat pose, mountain pose). Biofeedback training has also been reported to have benefits for
some people with this condition.

Anal Fissures
Anal fissures are small tears in the anal mucosa. Most often they are caused by constipation and
straining or passing large or hard stools. They can cause pain and bleeding during bowel movements.
Most resolve within a few weeks if caused by an isolated event, but constant constipation or straining
can prevent their healing. Like with hemorrhoids, the first treatment is resolving constipation (increase
soluble fiber, water intake and take stool softeners such as Butternut bark, magnesium, kiwi fruit or
prunes).

Once the underlying cause is being dealt with, sitz baths with Calendula, Plantain leaf and Witch Hazel
can be useful, as well as herbal suppositories made with cocoa butter, Hypericum oil, Gotu Kola,
Plantain leaf, Aloe gel, Comfrey leaf or Yarrow, and essential oil of Lavender can speed healing and
relieve pain, bleeding and itching.

Anal Pruritis (pruritis ani)

Rectal itching is not a serious condition but can be incredibly uncomfortable and embarrassing at
times. In addition to itching, there can be irritation, burning or soreness. Several conditions we have
already discussed, such as hemorrhoids and anal fissures, can cause pruritis ani. Other causes can
include poor anal hygiene, chronic diarrhea, skin conditions such as psoriasis or eczema, anal
infections, including Candida albicans or HPV, topical or dietary irritants, pinworms (mostly in young
children) and poorly controlled diabetes. Treatment consists of determining the underlying cause (if
possible) and treating it. Improved anal hygiene (cleaning well after a bowel movement, a bidet is
useful and less irritating than toilet paper) is important and the use of sitz baths (with Calendula,
Plantain leaf, EO of Lavender) can help heal irritated tissue.

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For rectal itching, Hypericum oil with menthol and EO of Lavender can give quick relief. For anal
Candida albicans infections topical applications of the dandruff shampoo Selsun Blue can also provide
relief.

Bibliography

Andarkhor, P., Sadeghi, A., et al, Effects of Terminalia chebula Retz. in Treatment of Hemorrhoids: A
Double-Blind, Randomized Placebo-Controlled Clinical Trial, Eur J Integ Med, 2019 Sep(30):100935

Belcaro, G., Cesarone, M.R., et al, Pycnogenol Treatment of Acute Hemorrhoidal Episodes, Phytother
Res, 2010 Mar;24(3):438-44

Belcaro, G., Cotellese, R., et al, Pycnogenol® Supplementation to Relieve Symptoms After
Hemorrhoidectomy, Minerva Surg, 2024 Jun;79(3):309-14

Belcaro, G., Gizzi, G., et al, Pycnogenol® in Postpartum Symptomatic Hemorrhoids, Minerva Ginecol,
2014 Feb;66(1):77-84

Bharat, G., Botanicals an Alternative Treatment Approach for Hemorrhoids-A Review, Ind J
Pharmaceutics, 2014 Jan-June;5(1):37-42

Chiaretti, M., Charetti, A.I., et al, Centella asiatica in the Conservative Treatment of Anal Fissure and
Hemorrhoids in Comparison with Flavonoids, EC Gastroenterol and Digest Sys, 2021;8;11:03-11

Corsale, I., Carrier, P., et al, Flavonoid Mixture (Diosmin, Troxerutin, Rutin, Hesperidin, Quercetin) in
the Treatment of I-III Degree Hemorrhoidal Disease: A Double-Blind Multicenter Prospective
Comparative Study, Int J Colorectal Dis, 2018 Nov;33(11):1595-1600

Dönmez, C., Yalçin, F.N., et al, From Nutrition to Medicine: Assessing Hemorrhoid Healing Activity
of Solanum melongena L. via In Vivo Experimental Models and its Major Chemicals, J
Ethnopharmacol, 2020 Oct;261:113143

Du, W., Chen, W., et al, Clinical Study on the Treatment of Complex Anal Fistula by Phased Chinese
Herbal Sitz Bath Based on “Fuzheng Quxie” Theory, Altern Ther Health Med. 2024 Feb;30(2):50-5

Eshgi, F., MD, Hosseinimehr, S.J, Ph.D, et al Effects of Aloe vera Cream on Posthemorrhoidectomy
Pain and Wound Healing: Results of a Randomized, Blind, Placebo-Control Study, J Alternat
Complement Med, 2010;16(6):647-50

Garg, P., Singh, P., Adequate Dietary Fiber Supplement and TONE can Help Avoid Surgery in Most
Patients with Advanced Hemorrhoids, Minerva Gastroenterol Dietol, 2017 Jun;63(2):92-6

Gravina, A.G., Pellegrion, R., et al, Evaluation of the Efficacy and Safety of a Compound of
Micronized Flavonoids in Combination with Vitamin C and Extracts of Centella asiatica, Vaccinium
myrtillus, and Vitis vinifera for the Reduction of Hemorrhoid Symptoms in Patients with Grade II and
III Hemorrhoidal Disease: A Retrospective Real-Life Study, Front Pharmacol, 2021 Dec 14;12:773320

Kang, Z., Yu, Y., Research Progress on the Application of Chinese Herbal Medicine in Anal Fistula
Surgery, Am J Transl Res, 2024;16(8):3519-33

King, D.E., Mainouse, A.G., et al, Dietary Magnesium and C-Reactive Protein Levels, J Am Coll Nutr,
2005 Jun;24(3):166-71
310
9
 2025 Medicines from the Earth Herbal Proctology - Winston

Li, P., Yu, G., et al, Meta-Analysis of the Traditional Chinese Medicine Care Model in Relieving
Postoperative Pain in Patients with Anorectal Diseases, Heliyon 9 (2023) e22310

Liang, Y., Tankun R., et al, Natural Products with Potential Effects on Hemorrhoids: A Review,
Molecules, 2024;29:2673

Liao, W-C, Cheng, Y-Y, et al, Effects of Early Warm Water Sitz Bath on Urinary Retention and Pain
After Haemorrhoidectomy: A Randomized Controlled Trial, Int J Nurs Stud, 2024 Jun:154:104765

MacKay, D., Hemorrhoids and Varicose Veins: A Review of Treatment Options, Alt Med Rev,
2001;6(2):126-40

Mahmoudi, A., Seyedsadeghi, M., et al, Therapeutic Effect of Achillea millefolium on the
Hemorrhoids; A Randomized, Double-Blind, Placebo-Controlled Clinical Trial, J Herb Med, 2023
Jun;39:100657

Malekuti, J., Mirghafourvand, M., et al, Comparison of the Effect of Myrtus communis Herbal and
Anti-Hemorrhoid Ointments on the Hemorrhoid Symptoms and Quality of Life in Postpartum Women
with Grade 1 and II Internal Hemorrhoid: A Triple-Blinded Randomized Controlled Clinical Trial, J
Complement Integ Med, 2019 Aug 21

Mehdi, Z., Fatemeh, P., et al, Efficacy and Safety of Hemoheal Cream in Patients with Hemorrhoids: A
Randomized Double-Blind Placebo Controlled Clinical Trial, J Tradit Chin Med, 2021 Apr;41(2):301-
7

Mosavi, S.H., Ghahramani, L., et al, Topical Allium ampeloprasum subsp Iranicum (Leek) Extract
Cream in Patients with Symptomatic Hemorrhoids: A Pilot Randomized and Controlled Clinical Trial,
J Evid Based Integrat Med, 2015 Jan

Mott, T., Latimer, K., et al, Hemorrhoids: Diagnosis and Treatment Options, Am Fam Physician, 2018
Feb 1;97(3):172-79

Murshid, K.R, Hemorrhoids! Don’t Call the Surgeon Yet, Saudi J Gastroenterol, 1997 May;3(2):94-5

Nienhuijs, S., de Hingh, I., Conventional Versus LigaSure Hemorrhoidectomy for Patients with
Symptomatic Hemorrhoids, Cochrane Database Syst Rev, 2009 Ja 21;2009(1):CD006761

Perez-Miranda, M., Gomez-Cedenilla, A.G., et al, Effect of Fiber Supplements on Internal Bleeding
Hemorrhoids, Hepatogastroenterology, 1996 Nov-Dec;43(12):1504-7

Pitesa, R., Yuen, W.Y.R., et al, Flavonoids and Post Haemorrhoidectomy Recovery: A Systematic
Review and Meta-Analysis, ANZ J Surg, 2024 Sep;94(9):1480-90

Riss, S., Weiser, F.A., The Prevalence of Hemorrhoids in Adults, Int J Colorectal Dis, 2012 Feb;27
(2):215-20

Šabanović, M., Jašić, M., et al, Alpha Lipoic Acid Reduces Symptoms and Inflammation Biomarkers in
Patients with Chronic Hemorrhoidal Illnesses, Int J Vitam Nutr Res, 2018 Dec;88(5-6):281-90

Sha, Q., Cheng, M., et al, Effects of Huhuang Burn Liniment on Wound Healing and Changes in IL-10
and MMP-9 in Patients with Mixed Hemorrhoids, Am J Transl Res, 2022;14(10):7434-42
311
10
 2025 Medicines from the Earth Herbal Proctology - Winston

Weiss, R., Weiss’ Herbal Medicine, Classic Edition, Stullgart, Thieme, 2001

Workinger, J.L., Doyle, R.P., et al, Challenges in the Diagnosis of Magnesium Status, Nutrients, 2018
Sept 10;1202, 33 pp

Yousefi, M., Mahdavi, M.R.V., et al, Clinical Evaluation of Commiphora mukul, a Botanical Resin, in
the Management of Hemorrhoids: A Randomized Controlled Trial, Pharmacogn Mag, 2013
Oct;9(36):350-6

Zhou, M., Jin, W., et al, Traditional Chinese Medicine in the Treatment of Hemorrhoids-A Review of
Preparations Used and Their Mechanism of Action, Front Pharmacol, 2023 Oct 19; 14:1270339

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 2025 Medicines from the Earth Panel: Insulin Resistance - Alschuler

OBESITY MEDICINE ASSOCIATION: DEFINITION OF OBESITY

“Obesity is defined as a chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an
INSULIN RESISTANCE increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical
& WEIGHT forces, resulting in adverse metabolic , biomechanical, and psychosocial health
MANAGEMENT consequences.”

Thus, the dangers of obesity must be addressed in any weight loss effort.

I will focus on adipose tissue dysfunction.

ADIPOSE TISSUE DYSFUNCTION

VICIOUS CYCLE: INSULIN RESISTANCE & OBESITY
¡ In addition to storing calories as triglycerides, adipocytes also secrete a large variety of adipokines: proteins,
including cytokines, chemokines and hormone-like factors, such as leptin, adiponectin and resistin. (1)
¡ These molecules impact vascular function, immunity, bone metabolism, and neurological function. High Carb diet Stress, Fatigue, Hunger
¡ “The release of adipokines by either adipocytes or adipose tissue-infiltrated macrophages leads to a chronic
sub-inflammatory state that could play a central role in the development of insulin resistance and type 2 Leptin resistance &
diabetes, and the increased risk of cardiovascular disease associated with obesity.” (2) Hyperglycemia Increased inflammatory cytokines
¡ Insulin resistance leads to the release of free fatty acids from adipose tissue, increased hepatic production of very-
low-density lipoproteins and decreased high-density lipoproteins.

¡ Increased free fatty acids, inflammatory cytokines, adipokines and mitochondrial dysfunction contribute to impaired
Elevated Insulin Insulin Resistance
insulin signaling, decreased skeletal muscle glucose uptake, increased hepatic gluconeogenesis, and β cell
dysfunction, leading to hyperglycemia.
Increased TG (fat storage)
Calabro P, Yeh E, Subcell Biochem. 2007;42:63
Antuna-Puente B, et al. Diabetes Metab. 2008;34(1):2
Gallagher E, et al. Mt Sinai J Med. 2010;77(5):511

OBESITY & INSULIN DIAGNOSIS OF INSULIN RESISTANCE & METABOLIC SYNDROME

RESISTANCE
¡ Insulin Resistance HOMA-IR [Homeostasis Model Assessment of Insulin Resistance]:
¡ [Fasting plasma insulin (mU/L) x Fasting plasma glucose (mmol/L)]/22.5
¡ Many online calculators available

¡ IR likely present when:

¡ HOMA-IR > 2.0; The adult optimal HOMA-IR cut-off points for the presence of insulin resistance reported in the literature range
from 2.0 – 3.8
¡ [Tang Q, Drug Discov Ther. 2015 Dec;9(6):380-5]

Macrophages respond to ¡ Fasting Insulin > 3.16 uIU/mL -or-

the cytokine environment ¡ fasting G:I ratio of < 4.5 (<7 in teenagers and young adults)
in which they reside.
¡ If patient has fasting glucose >100mg/dL or HgA1c >5.6, metabolic syndrome likely if:
¡ visceral adiposity
¡ elevated TG >150mg/dL
http://d3md5dngttnvbj.cloudfront.net/content/bloodjournal/122/20/3415/F3.large.jpg
¡ waist circumference >40 in.(101cm) in men and >35 in. (80cm) in women
5 6

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 percentage of the remaining macronutrients. A classical biomarker
Calorie restriction of CHO restriction is the amount of circulating KBs.
Because of the simultaneous lowering of all three macronutrients Insulin and glucagon are key hormones regulating ketogenesis
and energy, CR induces a complex metabolic response that is not by controlling the flux of non-esterified fatty acids to the liver for
KB production.107 Paradoxically, C57BL/6 mice gain excessive body
2025 Medicines from the Earth Panel: Insulin Resistance - Alschuler
straightforward to attribute to one of these individual factors.
Mitchell et al.97 have shown that 10–40% CR over 3 months in weight, display hyperlipidemia, and have concurrently elevated KB
C57BL/6 mice (corresponding to approximately a tenth of their and glucose levels when fed an unrestricted KD with 410%
lifespan) decreases blood glucose, insulin and IGF-1 concentra- energy (E%) from protein.108,109 Thereby, insulin levels are only
tions, the latter showing the greatest dependence upon the slightly decreased, but drop significantly together with blood
severity of CR. glucose levels and body weight once calorie intake is also
Many of the metabolic effects of CR in model organisms are also restricted.109 This is in contrast to healthy humans where
observed in humans.5 CR reduces fasting insulin levels and unrestricted KDs with adequate protein intake tend to lower
improves insulin sensitivity in overweight individuals, whereby body weight and insulin levels,110 improve body composition by
these effects may be more pronounced with regular IF compared increasing fat-free mass110,111 and decrease inflammatory
with chronic CR.98,99 A CR diet supplying 600 kcal/day over markers.112 Some authors argue that CHO restriction should
8 weeks significantly decreased fasting insulin from 151 to be the first approach in the treatment of T2D, as it improves
65 pmol/l and glucose levels from 9.2 to 5.7 mmol/l in overweight long-term glucose control, lowers insulin levels and allows a
TARGETED METABOLIC SUPPORT individuals with T2D, with the greatest declines already apparent
METABOLIC EFFECTS OF DIET
reduction or even elimination of anti-diabetic drugs.113 Indeed,

FOR INSULIN RESISTANCE AND

OBESITY Table 1. Metabolic effect of various dietary restriction regimes in C57BL/6 mice and insulin-resistant humans

Parameter FGF21 IGF-1 Insulin Glucose BHB Body weight

¡ Caloric restriction
¡ Berberine (Berberis spp, Mahonia aquifolium, Species Mouse Human Mouse Human Mouse Human Mouse Human Mouse Human Mouse Human
Hydrastis canadensis)
Starvation C ↑ ↑ ↓ ↓ ↓ C ↓ ↓ ↓ ↑ ↑ ↓ ↓
¡ Magnesium Calorie restriction ↗a ↗a ↘a ↘a ↘ab ↘b ↘b ↘ab ↗b ↗b ↓ ↓
Protein-deficient diet, isocaloric ↑ ↑ ↓ ↓ ↓ ↑, — ↘b ↗b — — ↓ ↑
¡ Cinnamomum zeylanicum and C. cassia (True, Protein-deficient diet, ↑ ↑ ↓ ↓ ↓ ↘b ↘b ↘b — — ↓ ↓
hypocaloric
or Ceylon, Cinnamon, Chinese cinnamon) KD, isocaloric — — — — — —, ↓ ↑ —, ↓ ↑ ↑ ↑ ↓, —
KD, hypocaloric ↗a ↗a ↘a ↘a ↓ ↓ ↓ ↓ ↑ ↑ ↓ ↓
¡ Vaccinium spp. (Blueberries)
Abbreviations: BHB, β-hydroxybutyrate; FGF21, fibroblast growth factor 21; KD, ketogenic diet. a, mainly dependent on the degree of protein restriction;
¡ Camellia sinensis [Green tea] b, mainly dependent on the degree of CHO restriction. The protein-deficient diet is defined as a diet containing o 10E% protein. The KD is assumed to contain
410E% protein.
¡ Trigonella foenum-graecum (Fenugreek)

¡ Gymnema sylvestre (Gymnema)

Common denominator across the most successful diets = low calorie diets!
Oncogenesis (2016), 1 – 15
¡ Prunus cerasus (Tart Cherry)
¡ Exercise Klement RJ and Fink MK. Oncogenesis. 2016;5:e193.

CALORIC RESTRICTION COMPARISON BETWEEN IER/IF AND CER DIETS

¡ Animal studies have shown protective effects of daily continuous energy restriction (CER) and
weight loss on reducing tumor formation
¡ Over 100 years of research. ¡ Intermittent Energy Restriction (IER) commonly restricts caloric intake by 50%-
¡ However, CER is difficult to maintain, thus intermittent energy restriction (IER) or intermittent 70%, typically for 2-3 days per week
fasting (IF) have been studied as strategies with greater potential for compliance.
¡ Continuous Energy Restriction (CER) is commonly a 20% reduction in caloric
¡ Mirrors Paleolithic periods of food abundance and scarcity
intake that results in 5% to > 30% weight reduction
¡ Traditional Mediterranean diet includes periodic fasting
¡ Continuum of energy restricted diets: ¡ All diets reduce fat stores and thus lower levels of mitogens such as insulin,
IGF-1, estradiol, androgens, TNFa, IL-6, leptin, decreased kinase signaling,
Overnight Fast > 13 hr 2 days/week < 500 kcal/d 10%-15% continuous caloric restriction and increased adiponectin.

Harvie M and A Howell. Proc Nutr Soc. 2012;71:263-75. 9 Harvie M and A Howell. Proc Nutr Soc. 2012;71:263-75. 10

IER VS. CER AND WEIGHT

IER AND OXIDATIVE STRESS
¡ In 107 overweight pre-menopausal women, 2d of a 70% IER (2.71MJ/d) and 5d
Mediterranean-type diet per week was compared to an isocaloric 25% continuous ¡ CER reduces oxidative stress.
energy restricted diet for 6 months.
¡ The effect of IER on oxidative stress is not clear.
¡ Both diets resulted in reduced body fat: by 6.4kg in IER compared to 5.6kg in CER ¡ However, IER has been shown to increase cellular stress resistance, and increase
diet (P = 0.34) resistance to oxidative stress by ‘hormesis’, whereby repeated spells of moderate stress
¡ Reduction in fasting insulin and insulin resistance in both groups but greater in IER with IER increases the production of restorative proteins and antioxidant enzymes.
¡ Reductions in leptin, hsCRP, total and LDL cholesterol, TG ¡ This is also known as “adaptive homeostasis”, a process by which a damaging or
¡ Increases in SHBG and IGF-BP1 and IGF-BP2
stressful influence activates signal transduction pathways to increase the expression of
protective genes à prevention
¡ In another study of 51 men with DB2, IER (4.18 MJ for 4 d with 3 d regular diet/week)
¡ Conversely, this same damaging influence at high concentration and/or duration will lead to
v. CER (6.0–7.0 MJ/d) showed no difference in terms of weight or fasting insulin. damage

Davies J. GeroScience. 2017; 39:499.

Harvie MN, et al. Int J Obes (Lond). 2011;35(5):714-27. Mattson MP. Ageing Res Rev. 2008;7:1-7.
11 12
Ash S, et al. J Obes Relat Metab Disord.2003;27:797-802.

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 2025 Medicines from the Earth Panel: Insulin Resistance - Alschuler

LESS AGGRESSIVE FORM OF INTERMITTENT FASTING:

OVERNIGHT FASTING
CONCLUSIONS
¡ 13 -16 hours of fasting overnight to synch with circadian rhythms appears to reset the body’s
peripheral clocks leading to optimal clock gene expression and enhanced energy metabolism. ¡ Weight loss is more likely when insulin
¡ This study used data from the National Health and Nutrition Examination Survey. 1,066 sensitivity is increased via:
women were included.
¡ Changes in food timing
¡ Associations between nighttime fasting, HbA1c and 2-hour glucose concentrations were
examined. ¡ Caloric restriction

¡ Each 3-hour increase in nighttime fasting was associated with: ¡ Selected foods

¡ 4% lower 2-hr glucose measurement ¡ Botanicals and nutrients

¡ 20% reduced odds of elevated HbA1c ¡ Increased physical activity
¡ These improved biomarkers of glucose control may, in turn, reduce breast cancer risk given
the established association between HbA1c as well as fasting glucose and breast cancer
incidence.
13
Marinac C. Cancer Epidemiol Biomarkers Prev. 2015;24(5):783-9

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 2025 Medicines from the Earth Panel: Insulin Resistance - Chimelski

Initial Assessment: Finding the Patient's

Fostering Patient "Trailhead"
Empowerment Through Holistic Active Listening

Approaches Create space for patients to tell their stories, paying attention to values, barriers, and past
experiences with healthcare

Identify Readiness
. As practitioners, we have a unique opportunity to guide individuals toward Assess motivation, confidence, and capacity for change using targeted questions and validated

sustainable health transformations that honor their whole being. assessment tools. Food can be a very charged subject- ties into how we nourish and love
ourselves, somatic understanding of our bodies reparenting, indicator of safety, and so much
more. Some people its no big deal, others obsessive, others it can be really emotional stuff, be
ready for potential deep ties.

Find Entry Points

Practical methods for assessment, engaging patients in their own healing journey, Collaborate to discover small, meaningful "trailheads" - achievable starting points that align with
and creating supportive frameworks that foster lasting change. These evidence- patient values and lifestyle

based approaches emphasize collaborative care and patient agency while

Set Precise Direction
addressing the multifaceted nature of wellbeing. Develop concrete, measurable first steps with clear parameters for success

Finding the right starting point is crucial for sustainable transformation. By identifying small but meaningful entry
by lindsay chimileski points that resonate with patients' values and current capacity, we create a foundation for lasting change that can
gradually expand into broader health improvements.

The Power of Group Challenges Practical Tools for Kitchen Empowerment

Creative Experimentation Practical Recipe Collections Resource Guidance Kitchen Hacks
Community Building
Structured challenges that encourage trying Provide personally vetted cookbooks, Share time-saving techniques you use
Create spaces where patients can share
new foods, cooking methods, or meal patterns Curate simple, adaptable recipes that websites, and apps that align with yourself, along with practical tools that
experiences, recipes, and support each other
in a supportive environment use accessible ingredients and basic patients' specific needs, preferences, simplify healthy cooking.
through challenges and successes
techniques. and skill levels. Include clear rationale for Demonstrate these during appointments
Focus on templates rather than rigid why each resource might be particularly or through the group challenges when
instructions to encourage confidence helpful. possible to build confidence through
Gentle Accountability Joyful Reframing
and flexibility in cooking. modeling.
Provide structure and follow-up that motivates Shift narratives from restriction to exploration,
without shaming, celebrating all forms of emphasizing discovery and pleasure in healthy
progress choices Find flavor palates they like!

Group challenges transform the often isolating experience of behavior change into a collective journey. This social context helps patients see By sharing practical tools that demystify healthy cooking, we help patients overcome one of the most common barriers to sustainable dietary
their efforts as part of something larger, creating motivation that extends beyond individual willpower. The shared experience normalizes change. The emphasis should be on making healthy eating feel accessible and enjoyable rather than overwhelming or restrictive.
struggles while amplifying successes.

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 2025 Medicines from the Earth Panel: Insulin Resistance - Chimelski

Kitchen Herbalism for Blood Sugar Support

Culinary Herbs as Medicine Medicinal Mushrooms
Incorporate therapeutic doses of cinnamon, fenugreek, and Guide patients in adding reishi, lion's mane, and other
turmeric into everyday cooking, teaching patients to use these adaptogenic mushrooms to broths, teas, and everyday dishes
powerful allies in quantities that create real physiological for blood sugar regulation and immune support
effects

Spice Blends and Preparations Seasonal Adaptations

Teach simple techniques for creating personalized spice Help patients develop an understanding of how to shift herbal
blends, herbal honeys, and infused oils that make support based on seasonal availability and changing bodily
incorporating these powerful plants convenient and delicious needs throughout the year

Kitchen herbalism represents an accessible entry point to plant medicine that empowers patients while providing meaningful physiological
support. By teaching patients to work with therapeutic doses rather than culinary amounts, we help them harness these powerful allies for
blood sugar regulation and overall wellness.

Mindful Movement Practices

Nature-Based Physical Activity
Body Attunement
Practices that develop awareness of internal cues and sensations

Personalized Approach Reciprocal Relationship with Food

Movement that honors individual needs, limitations and preferences Functional Movement Patterns
Reconnection with Natural
Foster deeper understanding of food systems
Sustainable Integration Rhythms
Emphasize the diverse, whole-body through direct participation in growing,
Realistic scheduling and accountability measures
Guide patients in activities like gardening, movements inherent in activities like gathering, or harvesting, creating meaningful
hiking, and forest bathing that sync their foraging, gardening, and outdoor play that connection that translates to more mindful
Somatic Awareness
bodies with natural cycles and seasons, engage multiple muscle groups in functional, eating practices.
Techniques to process emotions stored in the body
reducing stress and improving sleep quality. varied ways.
Body Positivity
Cultivating appreciation for what bodies can do rather than how they look
Nature-based activities offer a unique form of physical engagement that nourishes both body and spirit. By reconnecting patients with the
ecosystems that sustain us, these practices foster a sense of reciprocity and belonging that can transform their relationship with food,
Mindful movement shifts the focus from exercise as punishment or calorie-burning to movement as a form of self-care and embodied presence. Through collaborative conversations, we help
movement, and their own bodies in profound ways.
patients identify activities that feel good in their bodies and fit realistically into their lives, making movement sustainable rather than another source of stress or shame.

Integrating Approaches for Lasting Change

Initial Assessment Embodied Practices
Identify meaningful "trailheads" for change and evaluate Support mindful movement and nature-based activities
readiness

Practical Tools Regular Reassessment

Provide kitchen resources, group challenges, and herbal Adapt approaches based on patient feedback and
guidance evolving needs

The most powerful transformations occur when these approaches are thoughtfully integrated and personalized to each patient's unique circumstances. By
meeting patients where they are and gradually expanding their toolkit of practices, we foster sustainable change that honors the interconnected nature of
health.

As healthcare professionals, our role is to serve as compassionate guides while empowering patients to become the primary agents in their own healing
journeys. Through this collaborative approach, we help create the conditions for lasting health transformation.

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 2025 Medicines from the Earth Panel: Insulin Resistance - Warner

Is your patient really body-aware?

Insulin Resistance/ Type 2 DM: • Teach them “Food Hacks” and help them notice a change in how they feel
•
Motivating Our Patients •
Move after a meal
Fiber, then protein, then starches
• Vinegar can denature the enzyme that breaks down starches
Wendy Warner, MD, ABIHM, IFMCP • No sweets by themselves
@wendywarnermd • Savory breakfast, not sweet

www.WendyWarnerMD.com • No starches alone; add fat/protein

“Glucose Revolution” by Jessie Inchauspe

• Continuous glucose monitors

• Menstruating women: glucose control varies with cycle

• Gather data and then do food hacks/ exercise changes
as needed
• Need tighter control in luteal phase
• Use a system designed for non-diabetics if they fit that
Is your patient • Perimenopausal women: IF often overridden by cortisol criteria
issues, hormone shifts Is your patient • Graphing in the apps too wide to see small changes
really • Menopausal women: watch muscle mass data-driven? • Goals (I’m really strict—these are “goals”)
body-aware? • Muscle impacts insulin sensitivity via AMPK
• Baseline under 100
• Muscle loss leads to dysregulated AMPK and worse
• Rise after a meal low and slow, like 30-40 points
glucose control
over baseline
• Fall back TO baseline, not below it

CGMs: things to be aware of More data: Bioimpedance assessments

• The scale lies

• Exercise typically causes a rise in glucose • Use these readings to adjust exercise/ movement
• Cortisol / adrenaline can cause a huge spike and very slow fall • Numbers you need to know:
• Cortisol shifts overnight can lead to hypoglycemia • Fat % (how much visceral?)
• Typically placed on back of upper arm; can be uncomfortable if very lean • Muscle % (take this with a grain of salt as organs look like muscle to some machines)

• Less accurate when placed on abdomen (though FDA approved for there) • BMR = basal metabolic rate

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 2025 Medicines from the Earth Panel: Insulin Resistance - Warner

Skinny-fat people
• They might be eating fairly well
Is your patient • They might be exercising a lot
overly busy or • They won’t understand how much adrenal dysfunction
anxious? impacts glucose control • Normal weight
• You gotta get them sleeping to help control all of this! • Under muscled
• Prone to glucose dysregulation due to changes in AMPK

Super Geeky

• Genetic testing that reports specific science-driven foods to eat for your
own genetic make up

319
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