Tinnitus-Ringing in the Ear, Treatment Options From Many Traditions

The Western allopathic approach to tinnitus is dramatically different from either Western Herbalism or Traditional Chinese Medicine in addressing this condition.

Western Allopathic Medicine: Tinnitus is the perception of sound when no actualindex3 external noise is present. Tinnitus is a non-auditory, internal sound that can be intermittent or continuous, in one or both ears, and either a low or high-pitch sound. The sounds of tinnitus have been described as whistling, chirping, clicking, screeching, hissing, static, roaring, buzzing, pulsing, whooshing, or musical. The volume of the sound can fluctuate and is often most noticeable at night or during periods of quiet. Tinnitus is often accompanied by a certain degree of hearing loss.

Tinnitus can be either an acute or temporary condition, or a chronic health malady. Millions of Americans experience tinnitus, often to a debilitating degree, making it one of the most common health conditions in the country. The U.S. Centers for Disease Control estimates that nearly 15% of the general public, over 50 million Americans, experience some form of tinnitus. Roughly 20 million people struggle with burdensome chronic tinnitus, while 2 million have extreme and debilitating cases.

In general, there are two types of tinnitus:

  • Subjective Tinnitus: Head or ear noises that are perceivable only to the specific patient. Subjective tinnitus is usually traceable to auditory and neurological reactions to hearing loss, but can also be caused by an array of other catalysts. More than 99% of all tinnitus reported tinnitus cases are of the subjective variety.
  • Objective Tinnitus: Head or ear noises that are audible to other people, as well as the patient. These sounds are usually produced by internal functions in the flow of blood or muscular-skeletal systems. It is often more like the sound of a heartbeat or pulsating. This type of tinnitus is very rare, representing less than 1% of total tinnitus cases.

index2Some medications such as aspirin, ibuprofen, certain antibiotics, and diuretics can be “ototoxic” or cause damage to the inner ear, resulting in tinnitus.

Other possible causes of tinnitus are:

  • Head and neck injuries
  • Loud noises,
  • Ear infections
  • A foreign object, or earwax touching the eardrum
  • Eustachian tube (middle ear) problems
  • TMJ disorders
  • Stiffening of the middle ear bones
  • Cardiovascular disease
  • Diabetes
  • Traumatic brain injury

There are also potential risk factors including the following:

  • Noise exposure from work, headphones, concerts, explosives
  • Smoking
  • Gender – men are affected more than women
  • Hearing loss
  • Age – older individuals have a higher likelihood of developing tinnitus

There is currently no scientifically valid cure for most types of tinnitus. There is, however, remedies that focus on diverting attention, addressing the emotional impact, and or cognitive therapy.

Western Herbalism: Tinnitus can serve as an important marker pointing to other potential health issues, since it a symptom and not a disease. Whatever the cause it tends to worsen in times of tension, stress and or muscle spasms. Stimulates like caffeine or nicotine, which increases vasoconstriction, can exasperate it. Furthermore, it can be caused by damaged fine hair cells of the inner ear. Although this cannot be reversed there might we some reduction felt in using some of the suggestions below. Stress reduction can often be helpful. Some herbs have been used to address tinnitus including black cohosh (Cimicifuga racemosa), goldenseal (Hydrastis canadensis) and more recently ginkgo (Ginkgo biloba).

Traditional Chinese Medicine (TCM): In TCM we know that the images6kidney qi communicates with the ears and that as we age or because of various states of health this can affect our qi, therefore the kidneys are often identified as root causes of tinnitus.

In approaching treatment of tinnitus, it is important to distinguish between an acute or sudden occurrence or a long-term tinnitus that gets worse over time or comes and goes. Furthermore, it is important to determine whether it is an excess-type or a deficiency-type of tinnitus. A key to this determination is that an excess type of tinnitus is often experienced in only one ear, while a deficiency based tinnitus tends to develop in both ears. The deficiency type usually gets better during the day and gets worse at night. A combination of deficiency and excess syndromes is possible, especially in persons with other illnesses or with tinnitus that has persisted for several years.

The following is a description of excess and deficiency patterns that might be able to better pinpoint treatment principles to be used.

Excess type #1, Hyperactive liver and gallbladder fire:

  • Sudden onset
  • Continual sound
  • Excess symptoms (a headache, flushed face, irritability)
  • Excessive anger, fright
  • Excessive use of alcohol

TCM formula: Long dan Xie Gan Tang (Gentiana Comb) with the addition of moutan, ligustrum, for persistent liver fire weakening the Kidney water.

Excess type #2, Phlegm Fire Syndrome

  • Intermittent ringing in the ears
  • Feeling of blocked ears
  • Chest stuffiness
  • Excess phlegm
  • Dizziness
  • Blockage manifesting as difficult urination or constipation

TCM formula: Wen Dan Tang (Bamboo and Hoelen Comb)

  • with the addition of pear, haliotis, uncaria (liver)
  • with lapis, scute, rhubarb and aquilaria (blockage of chest, constipation)
  • with dampness (Ban Zia Bai Zhu Tian Ma Tang)

Diet: avoid fat or spicy food

Deficiency type #1, Deficient Kidney Jing

  • Gradual worsening ringing
  • Dizziness
  • Backache
  • Deficient heat symptoms

TCM formula: Liu Wei Di Huang Wan (Rehmannia Six Formula) and schizandra.

TCM formula Er Long Zuo Ci Wan (Tinnitus Left Supporting Pills)

Deficiency type #2, Sinking Spleen Qi (yang def.)

  • Intermittently occurring tinnitus that is relieved through rest and reduced stress
  • Low energy
  • Poor appetite
  • Loose stools

TCM formula: Yi Qi Chong Ming Tang (Ginseng, Astragalus and Pueraria Comb.)

Lifestyle: stress reduction, adequate kidney and spleen building dietimages5

Ear Massage: There are several sites that have detailed directions for addressing tinnitus through massage:

The bottom line is that the early intervention is necessary for long-term success. If you are experiencing any of the symptoms outlined in any of the treatment options, seek the advice of a Physician or Clinical Herbalist (http://www.americanherbalistsguild.com/herbalists-and-chapters-near-you)

Sources:

Davis, Kathleen FNP. 2016. Tinnitus: Causes, Symptoms, and Treatment. The University of Illinois-Chicago, School of Medicine. Available from

http://www.medicalnewstoday.com/articles/156286.php

Flaws, B Sionneau P. 2001. The Treatment of Modern Western Medical Disease with Chinese Medicine. Blue Poppy Press. p. 55-56.

Hoffmann, D. 2003. Medical Herbalism. Healing Arts Press. P372-373.

Dharmananda, S. Ph. D. 1998. Treatment of Tinnitus, Vertigo, and Meniere’s disease with Chinese herbs. Institute for Traditional Medicine. Available from http://www.itmonline.org/arts/tinmen.htm

 

 

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Herbal Tinctures: Getting or Giving the Right Dose

tincturesHerbal tinctures are the backbone of Western herbalism.  Generally, herbal tinctures are made from herbs extracted with a combination of alcohol and water, although glycerine and vinegar can also be used.  They are widely available, economical to produce and use, compact enough to stock in considerable variety and have a good shelf life. They can be combined and are convenient to take.   Dried herbs start to loose their potency after 6 months yet tinctures can last up to 10 years or more.  As a primarily Traditional Chinese Medicine herbalist, I mostly rely on concentrated decoctions, but in some cases when I am working with aerial parts of  plants, or herbs that could benefit from the effects of alcohol, increasing circulation, tinctures are more appropriate.

This posting is based on tinctures made using the weight to volume method.

Understanding dosage rates are important in achieving therapeutic outcomes.  I find that if someone isn’t responding to an herbal formula then analyzing their dosages can be helpful.

As a starting point most commercially available herbal tinctures indicate the weight to volume ratio.  For example, if the label states that it is a 1:5 extraction, this indicates that 1 gram (weight) of herb is equivalent to 5 milliliters (volume) of liquid.

A tincture formula will state the herb and the ratio of herb (by weight) to solvent (by volume), and the % alcohol (ethanol) in water.

Having this information is crucial in understanding the amount of herb that you are recommending or taking per dose.  Furthermore, this information is required by law to appear on the label. along with the serving size suggestion, which we will discuss further on.

In trying to communicate dosage equivalencies I have developed the following chart based on weight to volume ratios.  The side column indicates the common ratios and the top row indicates the volume of tincture consumed (in milliliters).  For example, if you took 1 milliliter of liquid made at a ratio of 1:2 then you would be ingesting a half of a gram of herb.

Tincture Dosage Equivalencydosage ratioSuggested Use:  Different companies have different suggested dosage rates.   Some companies suggest taking a dropper full and others recommended taking a range of drops as a serving size, for example, 20-60 drops.  When a dropper full is suggested the amount consumed depends on the size of the bottle and dropper.  When the suggested dosage on the bottle indicates a number of drops per dose, the amount consumed depends on the viscosity of the liquid.  Since this can change from one company to the next the best we can do is to have an understanding of some equivalents  recognizing that this is an approximation:

  • 20 drops = 1 ml
  • Dropperful from a one-ounce bottle—30 drops
  • Dropperful from a two-ounce bottle—40 drops
  • 5 ml = 1 teaspoon
  • A one-ounce bottle holds approximately 30 ml, 6 teaspoons, 30 dropper full, and 1,000–1,200 drops.

For example if using the suggested serving of 40 drops, and 20 drops = 1 milliliter, then you are taking approximately 2 milliliters of a 1:5 tincture and getting approximately .4 grams of herb per dose.  Most commonly it is recommended to take the tincture two to three times a day, so using this same example you  would be consuming between .8 and 1.2 grams of herb per day. Knowing the actual amount of herb that is recommended on a daily basis will help with putting the this into context.  Below is a partial list of recommended daily dosage of some common herbs.

Examples of dosages of some common herbs*:

Herb Daily Dosage
Angelica archangelica 3-9 grams
Ashwagandha 3-12 grams
Astragalus 6-15 grams
Black Cohosh 3-9 grams
Burdock 3-10 grams
Codonopsis 9-30 grams
Dandelion 9-30 grams
Dang Gui 3-15 grams
Echinacea 3-9 grams
Grindelia 3-6 grams
Hawthorn Berry 6-12 grams
Lemon Balm ½-6 grams
Motherwort 10-30 grams
Oregon Grape Root 3-9 grams
Passion flower 3-9 grams
Skullcap 3-9 grams
St. Johns Wort 3-9 grams
Uva Ursi 3-6 grams
Valerian 3-6 grams

* Planetary Herbology, Michael Tierra

In some circles there has been a discussion that the use of alcohol potentizes the action of the herbs, therefore less herb is needed.  Furthermore, the synergistic action of herbal combinations or formulas also increases effectiveness requring less herb.  These are great discussions but I work with aspiring herbalists who are often confused as to how to determine or convert tinctures to actual grams of herbs.  I hope that this helps and would encourage you to take a moment to actually consider that you might not be taking enough herbs to be effective.

Related blog post:  https://herbalgoddessmedicinals.wordpress.com/category/herbal-preparations/

Up coming blog:  How to make tinctures using the weight to volume method.

 

 

More Than Medicinal: Herbal Love Medicine

I recently finished teaching a wildcrafting class on medicinal herbs of Central Oregon. This year I incorporated other cultural uses of plants, in particular, focusing on “Love Medicine”.love   Native peoples used plants, not only as medicine, but also for their ability to affect an outcome. Daniel Moerman, author of Native American Ethnobotany, offers a compilation of ethnographies with over a hundred stories of tribal use of plants including ceremonial, hunting, witchcraft and love medicine.

The term love medicine was used for plants that were often suggested by tribal healers, elders or through the oral transfer of information to have powers beyond their medicinal attributes. Both men and women would use various plants as love charms to lure potential suitors or hold the attention of a “special person”.   In researching this topic it is a bit murky how the plants were utilized. In some cases special perfumes were prepared, in others, rituals were conducted with specific plants. In the book Plains Apache Ethnobotany by Julia A. Jordan people spoke about tribal members who specialized in preparing “love medicines”. In this book, the author describes the use of perfumes that were worn during certain times and specific places. In Daniel Moerman’s book he briefly describes how various plants were used or prepared. As contemporary herbalism as evolved over the last century, many of these spirit-based uses are being lost to us. With that in mind, here are some plants surrounding Central Oregon and how they were used as “love medicine”.

Aquilegia formosa

Aquilegia formosa

Various species of columbine were used as Love medicine. Western Columbine (Aquilegia formosa) was used by the Thompson Indian’s who used it as a charm for women “to gain the affection of men”. The Pawnee along with the Ponca’s used the crushed seeds of columbine, as a love charm also used columbine as love medicine.

larkspur

Delphinium menzieessi

Larkspur, (Delphinium menziessi)- a plant that was toxic to livestock and considered poisonous ironically was used for love medicine. The Thompson tribe’s women used it “to help them obtain and hold the affection of men”, although it wasn’t clear on how it was utilized.

MeadowrueMeadowrue, of which Central Oregon has a few species was not used by local tribes but was used by the Potawatomi as both hunting and love medicine. The seeds were mixed with tobacco by and smoked by men when going to call upon a favorite lady. Meadowrue, (Thalictrum occidentale), was used by the Thompson as a poultice on open wounds for healing. Meadowrue’s root contains berberines, one of the few plants aside from Oregon Grape Root to contain that particular constituent. It was used to loosen phlegm, as blood medicine, and as an analgesic. The powdered fruits were mashed into a paste with water and used on the skin and hair.

spreading-dogbane-apocynum-androsaemifolium-01

apocynum-androsaemifolium

Spreading Dogbane (Apocynum androsaemifolium)-although considered toxic was used extensively by Native Americans as love medicine. The Okanagan-Colville tribe chewed the leaves and the juice, as well as, smoked the dried leaves as an aphrodisiac (Not advised). If you break a spreading dogbane stem or leaf, you will see that the plant contains a bitter, sticky, milky white sap. The sap contains cardiac glycosides that are toxic to humans. The root also contains a potent cardiac stimulant, cymarin. These toxic compounds help protect spreading dogbane from grazing animals. Despite its toxicity, the plant has been used medicinally for a variety of ailments. However, this plant is best enjoyed for its beauty and not as a medicine. Native Americans used the tough fibers of this and other native dogbanes to make threads and cord.

Platanthera leucostachys_Mono Lake Cty Park_2002-07.05

Platanthera leucostachys

Bog Orchid (Platanthera leucostachys)-a plant we recently identified in the Ochoco Mountains, was used extensively by the Thompson tribe as a wash for various joint and muscle aches. It was used in the sweat lodge for rheumatism. Women “hoping to gain a mate and have success in love” used the Bog Orchid as love medicine as a wash. Although I could find no report of its toxicity, it was only used externally, so beware.

arrowhead

Sagittaria latifolia

Arrowhead, (Sagittaria latifolia) which is found in northern Jefferson County and on the west side crest of the Cascades was used as love medicine by the Thompson is usually found at the margins of ponds or marshes. The enlarged rounded starchy tubers from the plant form at the ends of underground plant runners (rhizomes). When dislodged from the mud, these tubers will float to the surface. They are edible, and may be boiled or baked and eaten as a potato-like food. Native Americans harvested and consumed these tubers, which in some areas were known as wapato. The Thompson spoke about its use as a love charm and for witchcraft.

pineappleweek

Matriciaria disoidea

Pineappleweed (Matriciaria disoidea)- was used by native peoples ranging from Alaska to Montana. A close relative to German Chamomile it had similar uses for digestion and fevers.   Native peoples used the aromatic plants as perfume, sometimes mixing them with fir or sweet-grass and carrying the mixture in small pouches to concentrate the fragrance. Pineappleweed, provided a pleasant smelling insect repellent, and the fragrant dried plants were used to line cradles and stuff pillows.  The Okanagan-Colville buried the tops of Pineappleweed mixed with human hair to prevent loved ones or relations from going away.

prairie smoke

Geum triflorum

Prairie Smoke or three-flower avens (Geum triflorum)-is in the rosaceae family; so that tells us that it probably has astringent actions. Avens were used by many native peoples ranging from toothache remedies, fevers, antidiarrheal, gastrointestinal and as a gynecological aid. Primarily the roots were used. Several tribes used it for love medicine, including the Iroquois, who used the compounded roots as an emetic to vomit and cure themselves of love medicine. The Okanagan-Colville used and infusion of the roots as a love potion by a woman who wanted to win back the affection of a man. Mathew Woods wrote about it in his book The Earthwise Herbal: A Complete Guild To New World Medicinal Plants. He spoke about the roots of avens containing phenols, tannins and essential oil, along with noting that he felt Prairie Smoke has an affinity to the female system: the latter for Stagnant blood .

sierra shoot star

Dodecatheon jeffreyi

Last but not least Sierra Shooting Star or Tall Mountain Shooting Star (Dodecatheon jeffreyi) was used as love medicine by the Thompson tribe. Women used the flowers “to obtain the love of men and to help them control men”.

This is just a small sampling of the vast number of plants that were utilized. As the profession of herbalism evolves in North America there is greater and greater emphasis being put on evidenced based medicine and a movement away from traditional knowledge along with the reduction in the number of the plants that are used in commerce. Despite this tendency towards retraction, my hope is that we continue to keep love 2plant stories, and other cultural values which plants offer, alive.

Teasel, Wild Rose and Parsnipflower Buckwheat

It is that time of year to get out in the woods and start identifying medicinal herbs, shrubs, trees that grow in Central Oregon (Crook, Deschutes and Jefferson counties).   This year I will be doing my first official plant walk through COCC into the Ochoco’s National Forest and am excited to be sharing this info with others who have an interest in plant medicine.

This past weekend I attended a wildflower walk with our local land conservancy non-profit.  They were showcasing a large-scale project bringing back the historical flow of the Whychus river.  As much as I enjoyed the hike and appreciated the project they were undertaking, I was struck by the language the leaders of the plant walk used when talking about plants that they considered “bad” in relationship to their conservation efforts.  I certainly understand the importance of ecological balance based on historical misuse of land and how some plant species adapt and out-compete other plant populations, yet when one of the attendees asked about whether a particular plant was a “good” plant or a “bad” plant (mullein) it doubled my efforts to try to expose more people to the value that plants contribute to the health of our planet and ourselves.  I realize this is an uphill battle, but the slash and burn terminology and disregard of the value of plants in the name of conservation, is an issue near and dear to my heart.

Below are a few of the plants and their medicinal values we found on the hike.

IMG_3978

Hercules eriogonum

As usual there are many different common names for this particular plant.  The folks on the plant walk referred to it as Northern Desert Buckwheat, Peterson’s Field Guild-Western Medicinal Plants and Herbs,  refers to it as Umbrella plant, Moerman-Native American Medicinal Plants refers to it as Parsnipflower Buckwheat, yet all indicate its Latin name to be Hercules eriogonum from the buckwheat family.  An important lesson in the use of Latin names to make sure everyone is referring to the same plant.  Native American historical use by the Okanagan-Colville tribes indicated that the roots and stems were taken for colds.  They also used it topically as a poultice (smashing the leaves) for cuts and sores, or as a decoction (cooking) of roots and stems in a wash for infected cuts.  The Thompson tribe used it as pain medicine, the leaves were used as disinfectant, an infusion was used for ceremonial purposes for purifying the sweat house, a steam bath of the for rheumatism, infusion and decoction of the plant used in lung disease.  Key attributes:  analgesic, antirheumatic, disinfectant, dermatological, gastrointestinal aid, and pulmonary aid. *sources:  Steedman, E. V. 1928.  The Ethnobotany of the Thompson Indians of British Columbia, Smithsonian Institution.  Turner, Nancy J. et al. 1990. Thompson Ethnobotany:  Knowledge and Usage of Plants .  Victoria: Royal British Columbia Museum.

IMG_3985

Fullers Teasel, Dipsacus fullonum

Fullers Teasel, Dipsacus fullonum Originally from Europe and northern Africa, common teasel was first introduced to North America in the 1700’s and has since spread from coast to coast and is considered a noxious weed.  The genus name is derived from the word for thirst and refers to the cup-like formation made where sessile leaves merge at the stem and capture rain water.   There has been some evidence that this water provides a natural insect barrier to sap sucking aphids.  As is the case of many plants they have been used for dyeing fabric.  A blue dye obtained from the dried plant is substitute for indigo and yellow is obtained when the plant is mixed with alum.  The plant contains theine (caffeine), tannin, gallotannic acid, boheic acid, volatile oil, aqueous extract, protein wax, resin, ash and theophylline.  There is little evidence of its use by Native Americans with the exception of the Iroquois who used it as a dermatological aid, infusing the leaves in a tea as a wash for acne.  They considered the roots were poisonous.

In the past, people believed that the rainwater that collected in the bowl-like depression of teasel leaves was helpful in providing relief from irritation and swelling in the eyes.  In ancient Greece, Dioscorides thought the root of teasel possessed purifying attributes and suggested the use of a decoction prepared by simmering the roots of teasel in wine for treating warts as well as fistulas effectively. In addition to Dioscorides, several other herbalists of the ancient times also advocated the use of the roots of this herb to treat jaundice and as a diuretic to augment the flow of urine.

There has been more recent exploration of the value of Dipsacus follunum root tincture (low dose) by herbalist Matthew Wood in treating chronic inflammation of the muscles, one of the major symptoms caused by spirochetes associated from Lyme Disease.  In fact the  Journal of the American Herbalist Guild, volume 11/number 2/Autumn 2013 published a special issue on Herbal Treatment of Lyme Disease, including information on the use of teasel.  An overview of the use of teasel in the treatment of Lyme can be read at the following web site:  http://www.flaatthjelp.net/to-sma-flattbitt/teasel/

According to the Scottish School of Herbal Medicine who conducted wrote an abstract on two types of Dipsacus utilizing first a systematic literature review consulting historic and modern texts and second a semi-structured interview was conducted with three herbal practitioners skilled in teasel use. The results were analyzed using thematic analysis, a qualitative method, and the results or themes composed separately. Both forms of literature were then compared and contrasted to ascertain Dipsacus spp’s therapeutic properties.  Analysis of the interview and literature data appears to show that teasel still holds a place within the British herbalist’s dispensary and is suitable for treating chronic skin disorders and musculoskeletal inflammation and damage. With our over-reliance on importing herbs from all corners of the Earth, this nuisance plant may once again fulfill a role within our modern dispensary.

index

Rosa woodsii, Woods’s Rose

A shrub, Woods’s Rose, was also pointed out during the walk.  Wild roses are a bit hard to identify so my best attempt was Rosa woodsii.  Roses has been used historical by cultures throughout the world with all of parts of the shrub finding their way into our materia medica.  In fact it is far beyond the scope of this post to elicit all the wonderful attributes of roses on our health and psychic. In the America’s many tribes used a variety of wild rose species.  In this bioregion the Paiute tribes used a decoction of the root for diarrhea, a poultice of various parts of the plant as a burn medicine, a decoction of the inner bark of the shrub for colds, a poultice of the  mashed fungus galls for open boils, and an infusion of the leaves were taken as a spring tonic.  The Thompson tribe used the hips to help women in labor to hasten delivery and a decoction of the roots were taken by women after childbirth to tonify the uterus.  They also made a decoction of branches of rose, chokecherry and willow for diarrhea and vomiting.  Pioneer women used the hips of wild rose in jelly, pudding and syrups.  Kiva Rose has an outstanding write-up of the multiple ways that you can utilize rose in medicine and food. http://medicinewomansroots.blogspot.com/2007/05/sweet-medicine-healing-with-wild-heart.html

Herbal  Goddess Medicinals provides this information as a way to continue to educate ourselves about the medicinal use of plant.  Never use any plant unless you are 100% of its identification and  always seek advice from a professional before using a plant medicinally.

Calamus-Smart Soup, Brain Protectant and Traditional Uses

Calamus, Sweet Flag, Acorns calamus, Vacha, Shi Chang Pu, rhizoma acori tatarinowii(石菖蒲)

Recent research from the Chinese Academy of Sciences’ Institute of c4f6301f8e8504f05b68c1b5d558dacdBiochemistry and Cell Biology in Shanghai found a traditional Chinese medicine known as smart soup (聰明湯) could help in the fight against Alzheimer’s disease, of which calamus was one of the ingredients.  The soup, which is a Traditional Chinese Medicine (TCM) formula used for many centuries and is still prescribed by Chinese medical physicians to patients with aging-related cognitive impairment.  Smart Soup is officially documented in Gu Jin Yi Jian, a book published in 1576.  It is composed of Rhizoma Acori Tatarinowii (calamus), Poria cum Radix Pini and Radix Polygalae.  Calamus has been shown to exhibit a neuroprotective action and attenuate learning and memory deficits.  According to the research the scientists found the smart soup, or more specifically radix polygalae, could significantly reduce the generation of amyloid beta, with the levels in treated mice more than 18 per cent lower than in those untreated.  They found that the other two herbs – rhizoma acori tatarinowii (calamus) and poria cum radix pini – appeared to protect the neurons against the damaging effect of ama.

index1According to Traditional Chinese Medicine (TCM) calamus is aromatic, acrid, bitter and warm. It belongs to the category of aromatic substances that open the orifices and enters the Heart and Stomach channels. It strengthens the Spleen and Stomach, opens the sensory orifices, dislodge phlegm, transforms dampness, calms the spirit, enhances digestion, and promotes blood flow and movement of Qi. It is often used in the treatment of dizziness, dulled senses, stupor and coma.  It has been combined in many other formulas including:

1) Di Tan Tang from Ji Sheng Fang (Life-saving prescriptions). It is combined with Ban Xia (Pinellia), Tian Nan Xing (Arisaema), Ju Hong (Exocarpium Citri Erythrocarpae), etc. to treat stoke due to phlegm confusing heart, unconsciousness, and a hardened or stiff body of the tongue impeding speech.

2) Chang Pu Yu Jin Tang from Wen Bing Quan Shu (Complete Compendium of Warm Disease). It is formulated with Yu Jin (Tumeric Tuber), Pinellia, Zhu Li (Succus Bambusae), etc. to cure blocking of phlegm-heat, high fever, coma, and delirium.

3) Qing Xin Wen Dan Tang from Gu Jin Yi Jian (Mirror of Ancient and Contemporary Medicine). It is coupled with Zhi Shi (Citrus Aurantium), Zhu Ru (Bamboo Shavings), Huang Lian (Coptis Root), etc. to heal epileptic seizures caused by phlegm-heat.

4) Ru Lian Po Yin from Huo Huan Lun (Treatise on Cholera). It is matched with Coptis, Hou Po (Magnolia Bark), etc. to treat dampness forming with heat, retention of damp-heat, vomiting and diarrhea accompanied with fever, chest and epigastric fullness and distress, and yellowish glossy coating of the tongue.

5) Kai Jin San from Yi Xue Xin Wu (Medical Revelations). It works with Coptis, Fu Ling (Poria), Shi Lian Zi (Sinocrassula indica seed), etc. to cure no desire to eat and rectal tenesmus after dysentery due to the accumulation of damp turbidity and heat toxic in colon.

6) Bu Wang San from Zheng Zhi Zhun Sheng (The Level-line of Patterns and Treatment) and Kai Xin San from Qian Jin Fang (Thousand golden essential prescriptions). Both of them are equipped with Ren Shen (Ginseng), Poria, Chang Pu (Acorus calamus), etc. to heal forgetfulness.

The article on smart soup peaked my interest, in that I knew that calamus also played an extensive role in Ayurveda herbal traditions, as well as, in Native American use.

Calamus, is a tall perennial, wetland monocot in the Acoraceae family.  It index4is a strongly aromatic, semi-aquatic perennial herb with a ginger-like stem which spreads into the ground. Originating in Asia it was widely exported across the globe.  The leaves and rhizomes have been used medicinally and as a substitute for ginger, cinnamon and nutmeg.  The aroma of calamus essential oil is valued in the perfume industry while its, crystallized form, is called “German ginger”.

index6In Native American traditions calamus has been extensively used for a variety of conditions and is considered by some tribes as a panacea herb or cure-all.  Used by Canadian, northern and mid western tribes, its use ranged from treatment of digestive issues to blood medicine and everything in between.  The Cherokee, from which I descend, used it for headaches, diarrhea, gas, colic, colds, kidney disease, worms and urinary infections.  It was ground up and mixed with tobacco and smoked for headaches by the Blackfoot. An infusion of the roots along with chokecherry was taken for coughs by the Algonquin tribe from Quebec.  Not only used internally calamus was used in charms for keeping spirits away, to protect warriors, keep children safe and as hunting medicine by the many of these tribes.  The most common use of calamus throughout all tribes was as a carminative, tooth aches, cold remedies, and sore throats.  In a review of ethnographic records, it had limited use as a herb for improving clarity of thought , although the Rappahannock specifically used the fresh juice as a tonic for older people and several other tribes considered it a beneficial tonic.

In western pharmacology it is classified as a stimulant, emetic, nauseant, stomachic, aromatic, expectorant, carminative, antispasmodic and nervine sedative, antioxidant and antimicrobial.

acorus%20calamus%20(2)In Ayurveda calamus is known as Vacha.  It has been used in nervous system issues and for mental and emotional disorders.  It has been used to quite the mind especially in the case of disorders characterized by an impairment of concentration such as ADD and ADHD.  As in other herbal traditions it is used in digestive disturbances.  Todd Caldecott, an esteemed herbalist specializing in Ayurveda, wrote an extensive monograph about its use.  In Ayurvedic tradition, Vacha is a ‘sattvic’ herb in its action as a stimulating nerve tonic that helps support brain functioning. It is also used as a rejuvenate for the brain and nervous system, it is used to promote cerebral circulation and to help support overall brain health and functioning. It has long been used to counter the effects of drug use, as in the case of heavy marijuana use, from fatty tissues within the liver, nervous system and brain. It is often used in post-Stroke (CVA) recovery protocols in the treatment of aphasia.

There has been some concerns regarding its safety. Calamus and products derived from it (such as its oil) were banned in 1968 as food additives and medicines by the United States Food and Drug Administration. Per the FDA’s website “Food containing any added calamus, oil of calamus, or extract of calamus is deemed to be adulterated in violation of the act based upon an order published in the Federal Register of May 9, 1968 (33 FR 6967)”. 

Jim McDonald a highly respected herbalist wrote extensively on calamus and is excellent reading.  According to information from his website and through info gleaned various other internet searches the ban was the result of a laboratory study that involved supplementing the diets of rodents over a prolonged period of time with massive doses of isolated chemicals (?-asarone).  The subject animals developed malignant tumors, and the plant was thereafter labeled procarcinogenic, although it  is not clear whether the observed carcinogenic effect in rats was relevant to the human organism, particularly given the large dosages and protracted duration of the regimen. Most authorities advise against ingesting the Indian Jammu strain. (Four varieties of Acorus calamus strains exist in nature; diploid, triploid, tetraploid and hexaploid. Acorus calamus americanus is widely used and believed completely safe in appropriate therapeutic dosages). No health hazards or side effects are known in conjunction with the proper administration of designated therapeutic dosages of Calamus of European or American origin (triploid strain, up to 15% beta- asarone in volatile oil)  but long-term use of this herb should be avoided and use should be intermittent.

Other sites with extensive information on calamus:

http://www.herbcraft.org/calamus.htmlhttp://toddcaldecott.com/herbs/vacha/

http://www.mariatrebenherbs.com/?pid=55&sid=57:CALAMUS-SWEET-FLAG

use as essential oil-http://oilhealthbenefits.com/calamus-essential-oil/

Information on Smart Soup Research

ww.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0111215

Seeds available through Horizon Herbs

https://www.horizonherbs.com/product.asp?specific=384

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Insomnia and Natural Strategies to Sleeping, Part 1

I teach a variety of classes and the class that is the most well attended is my class on naturalsleeping strategies for sleep and insomnia.  As a Traditional Chinese Medicine (TCM) herbalist, I cover this topic from both a TCM and Western viewpoint, as I will in this blog.  When I first started putting together the research for the class a quick search on the internet reveals enumerable sites devoted to sleep issues.  According to some estimates, 30% of the population experiences trouble sleeping.

Although there have been studies linking lack of sleep to long-term clockhealth issues it is important to not get too stressed out.  My experience in working with clients has been that anxiety about not getting enough sleep is a vicious self perpetuating cycle. If you are anxious about your sleep it may effect your ability to fall asleep or remain asleep. When this happens for many nights (or many months), you might start to feel anxiousness, dread, or panic at just the prospect of not sleeping. This is how anxiety and insomnia can feed each other and become a cycle that  may benefit from cognitive and mind body techniques.

For starters if you suspect that you have insomnia do any of these describe you?

  • Need an alarm clock in order to wake up on time
  • Rely on the snooze button
  • Have a hard time getting out of bed in the morning
  • Feel sluggish in the afternoon
  • Get sleepy in meetings, lectures, or warm rooms
  • Get drowsy after heavy meals or when driving
  • Need to nap to get through the day
  • Fall asleep while watching TV or relaxing in the evening
  • Feel the need to sleep in on weekends

If any of these seem familiar, then I would keep reading.  Lets take a look at some indicators that might help you determine whether or not you have insomnia and what type of insomnia it is is classified as.

  • Do you wake up during the night and find that you cannot fall back asleep?
  • Do you lie in bed, tossing and turning for hours each night?
  • Do you dread going to bed because you feel like you never get a good night’s sleep?
  • Do you wake up feeling unrefreshed after sleeping?
  • Does the problem occur even though you have the opportunity and the time to get a good night’s sleep?

The persistence of insomnia is how it is classified according to sleep specialists.

Types of insomnia
Transient Short term 1 or 2 nights a week
Intermittent On and off, from time to time
Chronic Constant, most nights for a month or more

Understanding the mechanics of sleep can help us to understand some strategies of treatment. Current information on sleep indicates that we past through several cycles of sleep, some indicate 4 stages and others 5I1047stages_thumb stages.   These stages progress cyclically from 1 through REM and then begin all over again. A complete sleep cycle takes an average of 90 to 110 minutes. Over the course of the night, the amount of time we spend in a particular stage of sleep begins to shift.  Typically you tend to experience more REM sleep in the earlier hours of the night (e.g., 11p – 3a) and more REM sleep in the later hours of the night (e.g., 3a – 7 a).

Going to bed and increasing your sleep efficiency can be the first step in developing an individualized sleep strategy.  The goal of getting enough sleep is to wake up naturally before the alarm, or when you want to get up.  Below is a calculation you can use to determine your appropriate bed time.

Determining an ideal bed time
 Sleep cycle  90 minutes
 Average sleep cycles per night  5 cycles
 Multiply 90 x 5 450 minutes (7.5 hours)

Then count backwards from the time you want to wake-up time 7.5 hours and you have a starting point for your bedtime.

Now that you know when you should be going to bed the next step is to determine how efficient your sleep is.  This can be done through a simple calculation or there are several excellent sleep apps on the app imagesmarket that track your sleep based on movement and let you see the percentage of time you spend in various sleep states along with determining our sleep efficiency.  Although these are can not substitute for a formal sleep study, they do give you an idea of your sleep patterns.  To determine your sleep efficiency without a sleep app, take the amount of time you spend in bed asleep (minus all the awakenings you may have and how long it takes you to fall asleep), and divide it by the total time you spend in bed, you will get an estimate of the overall percentage of how efficiently you sleep.   In sleep science they like to see this number above 85%. 85% is considered normal and really good sleep efficiency is above 90%.

There are many issues that might cause insomnia including unhealthysleep and aging sleep habits, anxiety or depression, certain foods and medical conditions. As we age we have we have changes in sleep cycles and needs. Ultimately if you feel as if your judgement and energy levels are diminished by your lack of sleep it is time to do something about it.

We are what we eat, so the first line of defense is to reduce our intake of foods that contribute to insomnia.

  • Refined Carbs can drain the body of vitamin B, which the body needs to release serotonin.
  • Bacon  contains tyramine, which increases the release of norepinephrine, a brain stimulant that keeps you up. Others foods that contain tyramine include chocolate, eggplant, ham, potatoes, sauerkraut, sugar, sausage, tomatoes, and wine.
  • Alcohol  can make you tired in the short run but you’re likely to awaken in the middle of the night. Red wine in particular effects sleep in that it contains more substances that people are sometimes allergic to, such as tannins, prostaglandins, and histamines.  If you do have alcohol, timing and the amount is everything.  One drink at least a couple of hours before sleep can have the least effect.
  • Chocolate can elevate your energy levels with bioactive compounds like tyramine and phenylethylamine. Chocolate also contains sugar which wakes you up as well as the other obvious culprit, caffeine.

Foods to incorporate into your diet that contribute to sleep include:

  • Walnuts-Walnuts are a good source of tryptophan, a sleep-enhancing amino acid that helps make serotonin and melatonin.
  • Almonds are rich in magnesium
  • Dairy products, Calcium (found in cheese, yogurt, milk) helps the brain use the tryptophan found in dairy to manufacture melatonin.
  •  Cherries, particularly tart cherries, naturally boost levels of melatonin.
  • Chickpeas are also a good source of tryptophan.

Supplements (all supplements and herbs need to be researched for possible medication interaction):

  • 5HTP-is a popular compound derived from the amino acid L-tryptophan. It is also produced commercially from the seeds of an African plant (Griffonia simplicifolia). 5-HTP acts as a precursor to serotonin, which is a neurotransmitter that is essential for a good night’s sleep. 5HTP has side effects and has not had long term studies, so it is important to research this supplement before using.
  • Magnesium contributes to a good night’s sleepResearch has shown that even a marginal lack of it can prevent the brain from settling down at night. You can get magnesium from food including green leafy vegetables, wheat germ, pumpkin seeds, and almonds.   Lack of magnesium inhibits nerve cell communication, which leads to cell excitability. Magnesium glycinate is a form of magnesium that avoids the side effects of loose bowel.
  • Calcium is directly related to our cycles of sleep.  In a study published in the European Neurology Journal, researchers found that calcium is directly related to our cycles of sleep.  The study concluded that disturbances in sleep especially the absence of REM sleep are related to calcium deficiency.  Calcium helps the brain use the amino acid tryptophan to manufacture the sleep inducing melatonin.  
  • GABA-An amino acid derivative found in green tea, theanine has long been known to trigger the release in the brain of gamma-aminobutyric acid, or GABA activates the major calming neurotransmitters, promoting relaxation and reducing anxiety, but the body has difficulty absorbing supplements containing synthesized GABA.
  • Melatonin-A hormone that regulates the normal sleep/wake cycle. According to research, the body naturally produces melatonin after the sun goes down, letting us know it’s time to fall asleep.  An effective way to take melatonin is to 1 sublingual and a time-released melatonin tablet. Take the time release tablet first and then place the sublingual tablet under your tongue.
  • Theanine-An amino acid derivative found in green tea, theanine has long been known to trigger the release in the brain of gamma-aminobutyric acid, or GABA. Experts recommend theanine, which the body can easily absorb and, ultimately, use to boost levels of GABA. Does above 600 mg without physician oversight.
  • L-tryptophan-Some people take L-tryptophan to try to help them sleep. But research does not show that L-tryptophan supplements are a good or safe treatment for long-term insomnia.  L-tryptophan has been linked to a dangerous, even deadly condition called eosinophilia-myalgia syndrome (EMS). Furthermore they have myriad interactions with medication, so caution is advised.

Coming soon:

Part 2, an overview of herbal protocols and development of individual sleep strategies.

Part 3, an overview of how perimenopause and menopause effect sleep.