Popular Natural Remedies, Part II

This article is the second in a series of three articles about natural products. As in the first article, this one will confine itself to some of the more popular natural products getting press today, list their pros and cons, and offer some useful information about them. This information is not be construed as an endorsement of any particular product, but is merely meant to inform about products you or someone you know may be using to treat a medical condition.

A natural product that has gotten considerable press in the last 10 years is Evening Primrose Oil, which has been indicated in the treatment of a variety of clinical disease states. Evening Primrose Oil is indicated in the reduction of cardiovascular disease. In a study of 79 patients who took a dose of 4 grams of the product a day, serum cholesterol was lowered by 31 percent. There are several preliminary unpublished studies in obese individuals that shows that Primrose Oil may lower blood pressure. Further, there are studies that show it has lowered plasma platelet aggregation, thus reducing the risk factor for heart disease and stroke. One reported use of Evening Primrose Oil is in treating breast cancer and related disorders. Unfortunately, there are no good human studies available at this time for use in these diseases; only animal models exist. This product has also been indicated in the treatment of premenstrual syndrome mastalgia. There have been clinical studies that show significant reduction in breast pain in patients with nodular apolocystic breast disease. However, the studies on Evening Primrose Oil in PMS, while encouraging, are too small to glean a clinically significant conclusion. Evening Primrose Oil has also been extensively investigated in treating rheumatoid arthritis. There have been enough studies on this to conclude that there seems to be reduction of joint pain and stiffness; but it must be noted that the patients need to take Evening Primrose Oil for a minimum of three months to see any change in their condition. That is significantly longer than for prescription medications to achieve the same clinical results. Further, it must be taken five months before the optimum results are seen. The only known contraindication to Evening Primrose Oil are in patients diagnosed with schizophrenia or those receiving epileptic drugs, such as the phenothiazines, because of increased risk of temporal lobe epilepsy. The normal dose is 3-6 capsules per day, in 500 milligram capsules.

Among older patients, a product that has gotten a lot of press in the last five years is ginkgo biloba. This product has been indicated extensively in preventing neurological damage (i.e., stroke), and in having a positive effect on memory. Ginkgo is the world's oldest living tree species, and can be traced back almost 200 million years. The ginkgo trees were almost wiped out during the last Ice Age, and only survived in isolated parts of China. Commercially, ginkgo is grown on plantations in South Carolina, France, Japan, and South Korea. Ginkgo has been reported to help significantly with human memory. For the last three to four years ginkgo has been promoted extensively for the use in Alzheimer's patients. Unfortunately, most of these disease state treatment models were based on activities seen in mice, and not in humans. At this point, the use of ginkgo in the elderly population has proven to show, at best, slight improvement in memory. The product has not lived up to its claims of significant improvement in disease states such as Alzheimer's. Ginkgo seems to have a strong antioxidant activity (an ability to scavenge reduction oxygen forms such as pre-radicals). Because of this, the product is deemed to have some neurological protective properties, which may be relevant to people trying to prevent brain damage. Ginkgo has reportedly been used in the treatment of tinnitus and hearing disorder therapy. Again, we can only go on animal models in showing the GBE results in significantly decreased manifestations of tinnitus. In patients with hearing disorder, secondary to vascular insufficiency, about 40 percent of the people improved in 2-4 months. It should be noted that this is only in patients whose hearing loss was caused by a vascular insufficiency to the inner ear; hearing loss for other reasons are not effected by GBE. There are no known contraindications to this product. The only toxicity has been in ginkgo seeds in children in Japan. The dose is 120-160 milligrams of ginkgo biloba extract daily in three doses. A note of interest is that most of the research on GBEs are all products prepared by the Willmar Schwabe Company in Germany. It takes literally barrels of leaves to produce a few days' worth of usable extract, hence the need for large plantations where thousand of ginkgo trees are grown and leaves are harvested.

One of the more interesting natural products for lowering cholesterol is niacin. Anybody who reads vitamin bottle labels will find niacin is normally one of the components of the B vitamins present in almost any multi-vitamin mineral supplement. Niacin by itself, however, has been shown very effective in lowering total cholesterol and increasing good cholesterol, HDL. Niacin is normally dosed somewhere between 500 milligrams to 1,500 milligrams a day. Doses beyond 1,500 milligrams should only be used with the advice of your physician, because in higher levels niacin can cause elevated liver enzymes in some individuals. There is some debate about which form of niacin causes these elevated liver enzymes. The literature seems to support the fact that short-acting niacin will not cause the rise in liver enzymes, whereas the long-acting does. The main drawback to the short-acting niacin is it can cause rather acute flushing in individuals who take more than 200-300 milligrams initially in a single dose. This flushing can be reduced by taking an aspirin tablet about an hour before the niacin. People will develop a tolerance to niacin and can slowly increase to the higher dosage levels, although it may take 6-12 months to get to a therapeutic dose without the irritating flushing. Whereas niacin's effect on total cholesterol may not be as dramatic as prescription drugs, its ability to raise HDL—the good cholesterol—probably cannot be matched by any pharmaceutical product on the market.

Americans are obsessed with losing weight. There are no lack of bad diets and so-called experts to tell us how to lose weight. There are also a number of over-the-counter "natural" products to help suppress the appetite, many of them containing the drug ephedrine, derived from the ephedra. Ephedras are chemically related to the decongestants and are a natural stimulant equal to or stronger than caffeine when taken in a high enough dose. Many "natural" weight loss products contain ephedra in some form in order to give users a boost. Manufacturers realize that nobody wants to feel tired and worn out when they're losing weight, so they add a little kick to the product in order to make people feel better. As a healthcare professional, I'm somewhat concerned with this because I've seen people numerous times over the years with side effects from the ephedra. While most people can take the ephedra, and while these weight loss products generally do not have any particular side effects, this does not hold for all people. The ephedra can have a caffeine-like effect and cause insomnia or restlessness in some individuals. In people with hypertension, the ephedras can raise their blood pressure, predisposing them to cardiac events and stroke. People with irregular heart beats can find them worsened with ephedrine.