Herbal and Natural Therapies

Question 1

What genus do most ginseng belong to?

Answer 1

Panax genus

Question 2

derivation of Panax

Answer 2

• derived from the Greek ‘Panakos’ which means panacea
• pan = all
• akon = cure

Question 3

Chinese or Korean Ginseng

Answer 3

• ‘true ginseng’
• most studied form in scientific literature
• cultivated now in China, Korea, Japan, and Russia

Question 4

white ginseng (preparation)

Answer 4

peeled and dried root

Question 5

red ginseng (preparation)

Answer 5

steamed with root intact and then dried

Question 6

American Ginseng

Answer 6

• grows from Quebec to Florida
• grows in the shade of eastern hardwood trees
• is expensive to produce
• variety of ginseng is the material from which the active ingredient Cold-FX is produced

Question 7

Historical uses of ginseng

Answer 7

• chinese and north indigenous language
• aphrodisiac (maintains sexual potency in males)
• treat asthma, anemia and lower back pain
• root extracts given as general tonic to give added energy and to maintain health

Question 8

Adaptogenic uses of Ginseng

Answer 8

• increases the biological and mental resistance to stress
• improves mental efficiency, accuracy, and powers of concentration
• increases endurance by preventing over fatigue
• increases resistance to a wide variety of physical, chemical and biological stresses

Question 9

list the numerous active ingredients of ginseng extracts

Answer 9

• cyclic triterpenes glycosides
• saponins
• ginsenosides
• panaxadiols and panaxatriols
• panaxosides

Question 10

Cognitive effects of Ginsenosides

Answer 10

• have confusing and different CNS effects
• Rb-1 and Rg-1 have both stimulatory and inhibitory effects on the CNS
• Rb-1 increases choline uptake into nerve endings and facilitates acetylcholine release
• Rg-1 rescues neurons from ischemic damage and delays neuronal death
• ginsensides may act as agonists at GABA receptors

Question 11

Physiological effects of American Ginseng

Answer 11

• high Rb -1, very low amounts of Rg-1
• treatment of insomnia, indigestion, toothaches

Question 12

Physiological effects of Chinese Ginseng

Answer 12

• high Rg-1, low Rb-1
• health promoting effects
• ability to overcome fatigue and physical stress

Question 13

Ginkgo biloba

Answer 13

• ginkgo
• gymnosperm
• 50 million ginkgo trees are in cultivation for preparation of herbal supplements

Question 14

History of Ginkgo

Answer 14

• Shen Nung uses leaves to treat memory loss and breathing ailments
• tree introduced into europe and NA in 18th century (not commonly used)
• Ginkgo extracts now marketed

Question 15

Active Compounds in Ginkgo

Answer 15

• flavonoid glycosides (apignenim, myricetin, kaemferol)
• biflavones
• terpenes (ginkgolides, bilobalide)
• proanthocyanidins

Question 16

Ginkgo mechanism of action

Answer 16

• increases uptake of choline into presynaptic neurons
• increases number of muscarinic receptors
• increases uptake of serotonin
• inhibits MOAs that usually break down monoamines like dopamine

Question 17

Ginkgo effects

Answer 17

• vasodilation
• antioxidant
• shows improvement in memory in animal and human studies

Question 18

Hypericum performatum

Answer 18

• Saint John’s -Wort

Question 19

traditional uses of Saint John’s- Wort

Answer 19

• treatment of depression, insomnia, anxiety
• used in ancient Greece and medieval to ward off evil spirits

Question 20

Chemistry of Saint-John’s Wort

Answer 20

• at least 10 active compounds
• unclear which are responsible for pharmacological effect
• napthodianthrones
• terpenes, phenolic acids, flavonoids, phloroglucinols
• xanthones

Question 21

Possible Mechanisms of action for Saint John’s Wort

Answer 21

• hypericin (prevents breakdown of serotonin)
• flavonols (prevents breakdown of neurotransmitters)
• inhibits reuptake of neurotransmitters
• inhibits GABA reuptake and activates GABA receptors

Question 22

Zingiber officinale

Answer 22

ginger

Question 23

historical use for Ginger

Answer 23

• known use in china as early as 14th century BC
• ancient greeks and romans
• common import from Asia from 11 - 13 centuries
• mentioned in the koran as part of a divine drink
• ayurvedic herbal tradition

Question 24

Ginger preparations

Answer 24

• harvested (8-9 months after planing to make dried ginger powder, 5-6 months for fresh use)
• crystallized and candied and made into syrups
• make into ginger oil for flavoring
• drunk as ginger ale or ginger beer

Question 25

Chemistry of Ginger

Answer 25

• chemical composition affected by maturity at harvest, climate, geographic origin
• compounds primarily harvested from the rhizome of the plant
• ginger is 7% lipids
• oil extract contains terpenoids
• primary pungent chemical is aromatic ketone

Question 26

Effects of ginger

Answer 26

• increases bile emptying and gastric motility (good for digestion)
• antiulcer, anti-inflammatory, antipyretic, analgesia
• inhibits platelet aggregation
• antidepressant

Question 27

Ginger: Mechanism of Action

Answer 27

• eicosanoid inhibition
• serotonin receptor antagonsim
• substance P release

Question 28

Hydrastis Canadensis

Answer 28

• goldenseal
• comes from yellow scars left on rhimozome that appear in spring

Question 29

Historical Uses of Goldenseal

Answer 29

• indigenous americans used root as both dye and medicine
• in mid-19th century: used by European settlers to treat skin diseases, ulcers, gonorrhea and arrow wounds

Question 30

Goldenseal extracts now marketed

Answer 30

• powdered root is main form of trade
• often used in combination with other herbs
• cure all: cancer to heart disease and pain

Question 31

Chemistry of Goldenseal

Answer 31

• total of 21 alkaloids reported
• two primary constituents: ß-hydrastine, berberine and canadine

Question 32

ß- hydrastine (chemistry and application)

Answer 32

• discovered by Alfred P. Durand
• isoquinoline alkaloid
• insoluble in water, but freely soluble in alcohol and acetone
• formerly used as an astringent vasoconstrictor and uterine stimulant
• vasoconstricting properties

Question 33

Chemistry of Berberine

Answer 33

• quaternary ammonium salt from group of isoquinoline alkaloids
• dissolves in water easily
• usually found in roots, rhizomes, stems, and bark

Question 34

Applications of Berberine

Answer 34

• thought to be antimicrobial, antidiarrheal, antiarrhythmic, cytotoxic, anticariogenic and hypoglycemic
• absorption through skin and orally

Question 35

Berberine biological activities in humans

Answer 35

• blocking receptors in smooth muscle
• blocks potassium channels in the heart and reduces ventricular tachycardia
• inhibits intestinal ion secretion and toxin formation in the gut
• increases bile secretion

Question 36

Two hypotheses for the biosynthesis of ß-hydrastine and berberine

Answer 36

• amino acid hypothese (tyrosine+DOPA precursors of alkaloids)
• prephenic acid hypothesis (prephenic acid is the progenitor)

Question 37

Clinical studies on Berberine

Answer 37

• Cancer
• tested in vivo and in vitro
• antineoplastic and anti-proliferative mechanisms
• cell cycle arrest, induciton of apoptosis, anti-inflammatory activitites, inhibition of angiogenesis and metastasis

Question 38

Traditional uses of Goldenseal

Answer 38

• uses as paint and dyes
• makes teas, liquid extracts
• used it for colds and other respiratory infections
• infectious diarrhea
• eye infections
• topical ointment

Question 39

future for Goldenseal

Answer 39

• 21st century: discovery, development and manufacturing of botanical therapeutics is a like area of expansion
• botanical dietary supplements
• increased in use with passage of DSHEA
• active ingredients of few supplements have been fully characterized

Question 40

Cognition

Answer 40

• ability to intelligently process information
• processes include those involving memory, attention, perception, action, problem solving and mental imagery

Question 41

Solanaceae family members

Answer 41

• potato, tomato, eggplant
• all have cholinesterase inhibiting effects
• acetylcholine levels increase
• high concentrations of these may result in toxic effects

Question 42

Vicia faba

Answer 42

• Fava beans
• Fabaceae family
• contain significant amounts of L-DOPA
• would have to ingest several times a day to have a therapeutic use

Question 43

Golden Rice

Answer 43

• first generation of engineered rice does not create sufficient amounts of Carotene that lead to recommended daily levels of vitamin A
• new generation of rice with improved gene constructs does produce more carotenoids

Question 44

Panax quinquefolius

Answer 44

Cold FX

Question 45

Cold FX clinical studies

Answer 45

• randomized, double blind, placebo controlled
• published in peer reviewed journals
• studies show limited side effects and drug interactions

Question 46

why did UBC profs dispute the quality of the clinical trials done?

Answer 46

• address the lack of statistically significant results
• address the combining of results from two trials into one data set
• don’t think that you can say you did not get a cold due to taking this particular product when perhaps you woudn’t get a cold anywasy

Question 47

Problems with integration of herbal medicine with modern medicine

Answer 47

• active ingredients in plants are not often known
• effectiveness may be due to interactions of numerous compounds within the plant
• effectiveness may rely on immediate use of medicine following its preparation/extraction from the plant