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Hello dear reader! Thanks for returning. True to the fiery quality of summer, it's been a wonderfully dynamic month, complete with heat waves, backpacking-related overexertion, and tending the garden. I've been learning how to work smarter, not harder, and deeply engaging in the healing work with the plants. 

I'm reengaging in premed education, so I'm taking this time to rest up and prepare for the fall quarter. As a result, I'll be leaving the Olympia Free Herbal Clinic (and pruning many other extracurriculars). I have so many emotions- relief and liberation, but also some sadness and solemn reflection. (I will however stay in practice at Goldroot Botanical Medicine.)

This edition of the newsletter features-
  • research news
  • Oregon grape root plant profile
  • Clinic story: A case study on recovery.
  • Honey-lavender panna cotta recipe
  • Book review: Stories of Illness and Healing

I hope you enjoy what I gathered for you! Now, back to summer...

-Renée

Research News

Double-blind randomized controlled trials (DBRCTs) are the gold standard for evaluating new drugs or treatments. A recent meta-analysis of 6 DBRCTs suggests that behavior can have a serious impact on the trial outcomes and the effectiveness of a treatment.

The wound healing activity of the comfrey root extract is not attributed only to allantoin, but is likely the result of the interaction of different compounds present in the water extract of the root. A recent paper elaborates on the findings.

Dan Shen or Salvia miltiorrhiza has been captivating me lately. Its ability to correct immune signaling and support liver functioning has positioned it as a main herb in my practice, especially in chronic infections. A recent review summarizes its effects in CNS neuronal injury and degeneration. 2 groups of constituents, tanshinones and depsides, appear to be neuroprotective as a result of its anti-inflammatory and antioxidant activity.

Oregon grape root plant profile

Oregon grape root (Berberis nervosa) is a plant that I cannot practice without. If it went on strike, I'd be out of business. As a result of its role in supporting gut microbiology, glucose metabolism, and liver function, it's an indispensable ally when you're facing complex metabolic or endocrine dysregulation. To further display my reverence, Oregon grape root is the inspiration for the name and the logo of Goldroot Botanical Medicine.
 
There are many species of Berberis throughout the North American continent: B. vulgaris, B. nervosa, and B. aquifolia are a few. The plant colonizes areas quickly through rhizomes and is easily cultivated. It flowers in early Spring, sending up bright displays of sun-yellow flowers.
 
Botanists have been debating about the genuses Berberis and Mahonia for centuries, arguing the finer points of morphologic distinctions between species. Spiny leaves or spiny stems? Likeness of flowers? Fruit color? As with many contentions in taxonomy, it's a moot point. The last word from botanists was that the Berberis genus absorbed what was left of Mahonia. So for simplicity, I just use the Berberis genus name. (That is, until the winds of taxonomy blow in a different direction...) Berberis and Mahonia and their species are, for practical purposes, interchangeable. "Oregon grape root" as a designation is not one species. Rather, it's a meta-species concept.
 
The root is the primary plant part used. They are commonly gathered and prepared in the early to late fall, chopped and dried for tincture (most common) and tea (less so, too bitter). The berries are fairly sour (but make an excellent vinegar), and I'm not hip to leaf use.
 
You'll notice the root is bright yellow. This is due to the presence of the alkaloid berberine, for which Oregon grape is famous. Goldenseal is arguably more well-known in the marketplace as an antimicrobial herb. This is due to its berberine content, rendering Oregon grape root a sustainable and cost-effective substitute for goldenseal. As a specific compound, berberine has been shown to:
  • lower elevated blood glucose as effectively as metformin
  • lower elevated blood total cholesterol, LDL cholesterol, triglycerides and atherogenic apolipoproteins (apo B) (Apo B)
  • reduce hepatic fat content, improving liver function and glucose metabolism
  • display antifungal activity against Candida albicans
  • have antimicrobial activity and the potential to restore the effectiveness of beta-lactam antibiotics against MRSA
  • display antiparasitic activity against Giardia spp.
Berberine gets a lot of attention as an antimicrobial. An important thing to remember is that its activity is local. It's not a systemic antimicrobial.
 
In practice, Oregon grape root is an excellent choice for several ailments:
  • liver stagnation (TCM), which can manifest as sluggish digestion or constipation, poor nutrient absorption, hormone imbalance, skin inflammation, and fatigue
  • metabolic syndrome and PCOS
  • intestinal dysbiosis and yeast overgrowth
Oregon grape root cooling and drying in nature. So it's best for the person who is displaying heat signs (think red skin, agitation, skin eruptions and other signs of excess energy). It is often used in combination with other herbs. (Dandelion is an excellent pairing for liver function, or raspberry for gastrointestinal support). So if an individual is cold or dry in constitution, consider pairing it with a warming herb like ginger to balance the formula. 

In the Clinic

A case study about nervine herbs and recovery.

Female (Caucasian), age 44, height 5’7”, weight 265
Family and marital status: Married, mother of 2 children
Occupation: Unemployed (in chemical dependency treatment), previous construction worker.
 
Primary health concern: Depression, anxiety, obesity.
 
Secondary health concerns: Addiction support for methamphetamine use.
 
Health history: Shehas experienced familial substance use and domestic violence. She began using methamphetamine in her 20’s to manage appetite and weight. The birth of her second child prompted her to get treatment so her daughter can have a better life and upbringing. She has been experiencing several areas of imbalance:

  • Mood: depression and anxiety, panic attacks.
  • Neurological: Numbness in extremities, memory loss.
  • Immune: Recurring UTI and yeast infections.
  • Digestive: Heartburn, bloating, intermittent loose stools, receding gums, feeling of unease in stomach.
  • Endocrine (premenopausal): Irregular menses, bleeding between cycles, awake 2-4a.
  • Severe fternoon fatigue and energy at night (10-12p) since quitting meth
Observation: She seemed nervous (first time talking to an herbalist). Breathing seems labored. Complexion is chalky and pale. Did not examine tongue or fingernails due to perceived unease. Thinning hair. Prefers cold, dry weather.
 
Diet: High in processed foods, standard American diet.
Elimination patterns: Has a bowel movement once daily. Sometimes she experiences loose stools and an urge to defecate. Sometimes wakes at night to urinate.
Sleep: Does not have trouble getting to sleep, but usually wakes in the night.
Exercise and movement: 15 minute walks in the park daily.
 
Western assessment and diagnosis: The client is currently in treatment for chemical dependency. Stress is also clearly impacting her physiology, and reports more depression and anxiety with stress. I also suspect blood sugar dysregulation, and potentially insulin resistance. Her irregular menses and thinning hair indicate endocrine disruption as well. These call for HPA axis support as a cornerstone of long term herbal care, with calming nervine herbs for acute needs. Her liver also needs support as she endures chemical detoxification as well as hormone imbalances. 
 
Herbal treatment strategy:
  1. Support mood and soothe anxiety
  2. Support HPA axis
Herbal formulas:
60ml Good Mood formula
15ml Ashwaganda (Withania somnifera) root --a restorative adaptogen for anxiety, adrenal and cognitive function
15ml Milky oats (Avena sativa)—calming and restorative nervine for damaged nerves
15ml Skullcap (Scutellaria lateriflora) aerial parts—calming nervine for anxiety and chemical addiction
15ml Cordyceps sinensis anamorph—for energy support
Dose: Take 2ml 3 times daily.
 
Supplements:
  • St. John’s wort capsules (450mg whole powdered herb)- 2 capsules daily for mood improvement and liver support
  • Fish oil supplement – 1000mg daily
  • Magnesium (for insulin sensitivity and mood support)- 900mg daily
  • B-complex 500mg daily
Dietary recommendations:
  • Eat more healthy fats (coconut, avocado, ghee) and healthy protein (fish, chicken) in steady periods throughout the day (especially in the morning) for consistent energy levels
  • Obtain more fresh fruits and vegetables from food bank (produce deliveries on Monday)
    • bluberries for blood sugar control
  • Increase water intake
Lifestyle recommendations:
  • Practice “I am at peace” breathing meditation for stress

Outcomes and follow up: At her follow up visit she was no longer experiencing panic attacks or chemical cravings. She was experiencing leg cramps. She liked the formulas and wanted to keep taking them. She had difficulty eating more fruits and vegetables as she recently got several teeth removed. However, she had an appointment with a nutritionist in a couple of weeks. She looked like an entirely different person. Her complexion improved, and she was no longer fidgeting. She reported feeling calmer, however she still feels period of irritability and short temper. She felt proud of her sobriety and very excited about her progress. 

Honey-lavender panna cotta

Lavender is a cornerstone herb for easing nervous tension and supporting a clear, relaxed mental state. One of my favorite ways to use it is in food--I love its aromatic and floral contributions. And this recipe is truly glorious. 

1 1/2 t powdered grass fed gelatin
1 cup half and half or cream (or substitute non-dairy alternative)
1/4 cup honey
1 teaspoon dried lavender flowers
1 cup milk (substitute almond or coconut milk)
Fresh berries for serving

In a small sauce pan heat the cream, honey, and dried lavender until it reaches a light simmer and turn off the heat. Whisk to incorporate all the honey evenly, then strain out the lavender into a mixing bowl. Whisk in the gelatin and continue whisking for at least a minute to make sure no lumps remain. Then whisk in the rest of the milk.

Pour the mixture into a glass dish or ramekins, and put in the fridge to set. It will need at least 2 hours to set, but I like to wait at least 4.

To unmold it, lightly run a knife around the edge and invert onto a chilled plate. Garnish with fresh berries (even mint or lemon balm) and enjoy!

Stories of Illness and Healing by Sayantani DasGupta and Marsha Hurst (eds).
This is the first book since beginning this newsletter that I will deem a "must read". This is the first collection of its kind, a tapestry of women's narratives and experiences through the healing process, along with analysis of the themes asserted by the authors. It's medical anthropology and narrative medicine in its finest iteration: relevant, important, and transformative. The authors and contributors, true to the book's description, "bridges the artificial divide between women's lives and scholarship in gender, health, and medicine." 

Each essay and written work in the anthology draws on an impressive variety of written expressions: prose, short stories, essays, radio diaries, poems, and experimental poetry and literature. 
It is divided into seven sections: Body and self—the experience of illness; Diagnosis and treatment—relationships to the medical community; Womanhood—social constructions of body, sexuality and reproduction; Family life and caregiving; Professional life and illness; Advocacy—from the personal to the political; Advocacy—activism, education and political change.

Here's one of my favorite passages from Jasmina Tesanovic in All Patients are Political Women:

By definition, the patients should come first in a hospital. Everything rotates around our illnesses: the gadgets, the doctors, the money, the politics, the science. Somehow the doctors are trying to take it all away from us, to make us objects, invisible, as in those nineteenth century paintings in which twenty male doctors surround a hysterical woman, calling her a case and ignoring her, writing books about her and making careers without ever really hearing or seeing her. Now, in modern hospitals, all patients are political women. 

For anyone interested in gender, medical anthropology, narrative medicine, or literature & poetry, this month's book pick is for you. 
I assisted with the research and writing of this series, and if you're interested in medical cannabis and integrative cancer treatment, sign up to receive notifications for this series. 

Cancer patients have long known of the proven benefits of combining cannabis with their mainstream oncology treatments. But emerging research has created an upsurge of interest in its potential as an anticancer treatment. 

The biggest challenge for patients and caregivers wanting to learn more about how to incorporate cannabis into cancer care is the complete absence of reliable, educated and unbiased information on the subject. Until now.

Answering the urgent call for this information is The Intelligent Patient’s Guide to Cannabis and Cancer, a practical, patient-centered guidebook by internationally respected medical herbalist and herb-drug interaction expert  Jonathan Treasure. 

Register for the Dandelion Seed Conference 

The Dandelion Seed Conference is happening again! Join us at the Longhouse at the Evergreen State College October 9-11 2015. 

This is the third annual conference, focused again on herbal medicine for community and social healing. Early bird registration is now available for $150 here. 
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