Alternative medicine lectures by Dr. Refaat Hamed

Dr. Refaat Hamed
Sunday, 14 June 2015
Complementary and Alternative
Medicine

Introduction
The main goals of these lectures are :
- To understand the basics of alternative and complementary
medicine and its application in therapeutics.
- To get knowledge about the available (OTC) various herbal
preparations, nutritional supplements and homeopathy.
- To get knowledge about the role of the pharmacist to help
clients make an informed choice of available products/techniques
as well as monitoring the client use of these products.

Introduction: Complementary and Alternative Medicine (CAM)
 What is CAM? CAM is a term used to describe a diverse group of
healing systems that are not presently considered to be part of
mainstream medicine.
 Complementary medicine: refers to medical practices used together
with conventional medicine.
 Alternative medicine: is used in place of conventional medicine
(Allopathy; treatment of a disease with drugs having effects opposite
to the symptoms # Homeopathy).
 Homeopathy: Treating symptoms with minute doses of disease-
causing natural substances.
 Evidence-based medicine: is a form of medicine that aims to optimize
decision-making by emphasizing the use of evidence from well
designed and conducted research.

Introduction: Examples of CAM
1. The use of hypnotherapy together with pain medications to reduce
anxiety and enhance relaxation in people recovering from severe
burns.
2. Following a special diet rather than taking medications to treat
“Attention Deficit Hyperactivity Disorder” (ADHD) is an example of
alternative medicine.
3. The use of acupuncture for alleviation of vomiting and pain
associated with anticancer drugs.

Introduction: What is Integrative Medicine?
 Integrative Medicine: combines alternative medicine with evidence-
based medicine. Proponents claim that it treats the “whole person”. It
focuses on wellness and health rather than on treating disease, and
emphasizes the patient-physician relationship.
 For example, an integrative treatment for Alzheimer's disease may
include a combination of the following:
1. Medication that increase certain brain chemicals,
2. Antioxidants as vitamin E and Ginkgo biloba extract that scavenge
free radicals,
3. Changes in lifestyle (such as walking programs and relaxation
training) to reduce anxiety and improve behavior, and
4. Music therapy to strengthen the immune system.

Introduction: Classification of CAM?
The National Center for Complementary and Alternative Medicine
classifies CAM therapies into five major groups:
1. Alternative Medical Systems: built upon complete systems of theory
and practice. Examples include homeopathy, aromatherapy,
naturopathy, traditional Chinese medicine (TCM), and Ayurveda.
2. Biological Medicine: use of substances found in nature, such as
herbs, foods, and vitamins to promote health.
3. Energy Medicine: involves the use of energy fields to promote health.
One of the forms of energy medicine (known as bioelectromagnetic-
based medicine) involve the use of electromagnetic fields, such as
electro-acupuncture.

Introduction: Classification of CAM?
4. Manual Medicine: based on manipulation and/or movement of one or
more parts of the body. Examples include osteopathy ꞈ¢̳ ԛ҇£�⁶₅$�
physical therapy, massage and reflexology.
Reflexology: A natural healing art based on the principle that there are reflexes in the
feet, hands and ears and their referral areas within zone related areas, which
correspond to every part, gland and organ of the body. Through application of
pressure on these reflexes without the use of tools, crèmes or lotions, the feet being
the primary area of application, reflexology relieves tension, improves circulation and
helps promote the natural function of the related areas of the body.
5. Mind-Body Medicine: uses a range of techniques that help boost the
mind's ability to influence body functions and symptoms. Examples
include biofeedback, deep relaxation, hypnotherapy, prayer, support
groups, music therapy and yoga.

Introduction: Physical Therapy

Other Types of Alternative Medicine: Acupuncture
 Acupuncture is a treatment based on Traditional Chinese Medicine
(TCM), a system of healing that dates back thousands of years.
 At the core of TCM is the idea that a type of life force, or energy flows
through energy pathways (meridians) in the body. Each meridian
corresponds to one specific organ, or group of organs, that regulate
particular bodily functions.
 Acupuncture points, or the specific locations where needles are
inserted, are places where the energy pathway is close to the surface
of the skin.
 The theory is that by stimulating these point with a needle, we actually
trigger the body’s own healing mechanisms.

 Aromatherapy is the use of essential oils (volatile oils) from plants for
healing purposes.
 The word aroma in aromatherapy is misleading because essential oils
are not solely used as inhalants. They can also be massaged into the
skin or even taken orally (although this is less common). Whether
inhaled, absorbed, or ingested, essential oils are gaining new
attention as an alternative treatment for infections, stress,
inflammation and other health problems.
 The "smell" receptors (olfactory receptors) in human nose
communicate with two structures that are embedded deep in human
brain. These structures are amygdala and hippocampus. When
essential oil molecules are inhaled, they affect these parts of the
brain directly.
Other Types of Alternative Medicine: Aromatherapy

 Stimulation of these structures influences our physical, emotional,
and mental health. For example, lavender is believed to stimulate the
activity of brain cells in the amygdala in the same way that certain
sedative medications work.
 Aromatherapy massage is a popular way of using essential oils
because it works in several ways at the same time: it produces
benefits from absorbing the oils into the skin, from inhaling the oil's
vapors, and from the physical therapy of the massage process itself.
 Constituents of certain essential oils have antibacterial and anti-
fungal properties. Citrus oils may enhance immune function and
peppermint oil promotes proper digestion. Fennel and aniseed have
estrogen-like compounds which may make them effective in relieving
symptoms associated with menopause and the menstrual cycle.

 Other conditions for which aromatherapy may be helpful include
Alopecia areata (hair loss) , anxiety, insomnia, constipation (via
abdominal massage using aromatherapy), Pruritis (itching) and
Psoriasis
 People who use aromatherapy require fewer pain medications for
treatment of rheumatoid arthritis, cancer (e.g. use of topical
chamomile), and headaches (e.g. use of topical peppermint).

 The term Ayurveda is taken from the Sanskrit words ayus, meaning
life or lifespan, and veda, meaning knowledge.
 The basic principle of Ayurveda is to prevent illness by maintaining
balance in the body, mind, and consciousness through proper
drinking, diet, and lifestyle, as well as herbal remedies.
 The goal of Ayurvedic medicine is to prevent diseases before they
occur.
 Combining yoga with an Ayurvedic herbal remedy containing Winter
cherry (Withania somnifera), Boswellia (Boswellia serrata), and
Turmeric (Curcuma longa) can reduce pain and disability if you have
arthritis.
Other Types of Alternative Medicine: Ayurveda (life style)

 Hahnemann postulated a theory that “like cures like” or the “Law of
Similars”.
 This law states that when a substance in large doses causes certain
symptoms, in small doses it can cure the same symptoms.
 Some treatments in conventional medicine (allopathy) rely on this like-
cures-like principle; vaccines, for instance, introduce small doses of
an illness-causing agent to prevent disease.
Homeopathy

 Hypnotherapists typically use exercises that bring about deep
relaxation and an altered state of consciousness. Many people
routinely experience a trance-like state while they are watching
television or sitting at a red light.
 Hypnosis can actually teach people how to master their own states of
awareness. By doing so they can affect their own bodily functions and
psychological responses.
 Studies on children in emergency treatment centers show that
hypnotherapy reduces fear, anxiety, and discomfort and improves
self-control and cooperation with medical personnel.
 In another study, children significantly or completely recovered from
the following: obesity, asthma, fecal incontinence, anxiety, pain,
problematic habits (e.g. sleep walking, thumb sucking, nail biting).
Hypnotherapy

 Massage is a "hands-on" therapy in which muscles and other soft
tissues of the body are manipulated to improve health and well-being.
 Music Therapy: using music.
 Aqua-therapy: using water.
Massage, music therapy and aqua-therapy

 Clinical nutrition is the study of the relationship between food and the
well-being of the body. More specifically, it is the science of nutrients
and how they are digested, absorbed, transported, metabolized,
stored, and discharged by the body.
 Nutrients are substances that are involved in the creation of every
molecule in the body. Carbohydrates, proteins, and fats (called
macronutrients) are broken down (metabolized) to give the body
energy.
 Vitamins and minerals (called micronutrients) are not themselves
metabolized for energy, but they are crucial in helping the
macronutrients to be converted to energy, via enzyme-catalysis.
Nutrition

 Herbal medicine = botanical medicine = phytomedicine or
phytotherapy, refers to the use of the entire plant or any plant organ
(e.g. seeds, fruits, roots, leaves, bark, or flowers) for medicinal
purposes.
 Herbal medicines are crude drugs utilized for the treatment of
disease states, often of chronic nature, or to attain or maintain a
condition of improved health.
 Herbal drugs can be whole, fragmented or cut plants, parts of plants,
algae and fungi, usually in dried form but sometimes fresh. Certain
exudates (unorganized drugs). are also considered to be herbal
drugs.
 Herbalists prefer using whole plants rather than extracting single
components from them.
Herbal Medicine = Phytotherapy

 Dosage Forms? often used as food additives or as a
tea (Infusions, decoctions) or tinctures. Capsules, tablets, tinctures,
tintments, creams ….etc are also available in the market.
 For many herbs, the specific ingredient that causes a therapeutic
effect is not known. Whole herb/plant extract contains many
ingredients, and it is likely that these constituents work together
(synergistically) to produce the desired therapeutic effect.
 The therapeutic activity of a plant does not depend solely upon a
single readily identifiable constituent but upon the entirety of the
chemicals in the plant extract/product.
 Many factors affect how effective an herb will be (e.g. the climate, soil
quality, how and when it was harvested and processed).
Herbal Medicine = Phytotherapy

1. The extract of Digitalis leaves is far more active than the equivalent
content of pure digitoxin (a cardiac glycoside).
 The pure glycoside is sparingly soluble in water at body temperature;
hence its absorption from the GIT is limited.
 The leaves (part used) contain another constituent, the saponin
digitaline, which though is not a cardioactive compound, that assists
the dispersion of the glycoside (digitoxin) in water and facilitates its
absorption from the intestine.
2. Senna is an example of standardized crude laxative drug with a
mixture of components (mainly anthraquinone glycosides ) that is
more effective than the purified anthraquinones. The presence of
aloe-emodin glucoside synergistically elevates the potency of
sennosides about four-times.
Efficacy of Entire Herbal Drug: Examples

3. Chamomile flowers have well-known spasmolytic effects and are
used to treat cramps and stomach problems. The effects are due to
some water soluble flavonoids (e.g. apigenin) and sesquiterpenes
(e.g. bisabolol) found in the essential oil. No single component of
Chamomile is responsible for the overall activity of the crude drug.
This is also true for the anti-inflammatory effects of Chamomile.
4. Khellin (a furano-chromon derivative) in Ammi visnaga fruits is
insoluble in cold water but soluble in boiling water. Therefore the use
of Ammi visnaga necessities its extraction by decoction for a
comparatively long period.
Efficacy of Entire Herbal Drug: Examples

 Herbal drugs treat many conditions such as asthma, eczema,
rheumatoid arthritis, migraine, menopausal symptoms, chronic
fatigue, constipation, irritable bowel syndrome,…….etc.
 Herbal preparations are best taken under the guidance of a trained
professional. Patients are advised to consult their pharmacist, and/or
physcian before self-treating.
1. Ginkgo biloba, particularly as a standardized leaf extract known as
EGb 761 (Ginkor), seems to produce improvements in awareness,
judgment, and social function in people with Alzheimer's disease and
dementia.
 In a year-long study of 309 people with Alzheimer's disease, those
taking Ginkor (Tanakan) consistently improved while those on placebo
worsened.
What is herbal medicine good for?

 Ginkor contains approximately:
1. 24% flavone glycosides (primarily quercetin, kaempferol and
isorhamnetin),
2. 6% terpene lactones (2.8-3.4% ginkgolides A, B and C, and 2.6-3.2%
bilobalide).
3. Other constituents include proanthocyanadins, glucose, rhamnose,
organic acids, D-glucaric and ginkgolic acids.
 Ginkor has antioxidant properties as a free radical scavenger. It
promotes vasodilation and improves blood flow through arteries,
veins and capillaries. It inhibits platelet aggregation and prolongs
bleeding time.

2. Kava kava (Piper methysticum) has become popular as a treatment
for anxiety, but recent reports have traced liver damage to some
patients who have used kava so that the Food and Drug
Administration (FDA, USA) has issued a warning regarding its use
and other countries, such as Germany and Canada, have taken kava
off of the market.
3. St. John's wort (Hypericum perforatum) is an effective treatment for
mild to moderate depression.
 Hyperforin (a prenylated phloroglucinol derivative) is proposed to be
the active constituent responsible for the antidepressant and
anxiolytic properties of the extract of St. John's wort. It acts as a
reuptake inhibitor of monoamines, including serotonin,
norepinephrine, dopamine, and of GABA and glutamate.

4. Valerian (Valeriana officinalis) has had a long tradition for treating
insomnia, with the added benefit of producing no hangover feeling
the day after.
5. Echinacea preparations (from Echinacea purpurea and other
Echinacea species) may enhance immunity. In a study of 160
volunteers with flu-like symptoms, echinacea extract reduced both
the frequency and severity of cold symptoms.

 Because herbal products are unregulated, they are often mislabeled
and may contain undeclared additives and adulterants.
 Some herbs are associated with allergic reactions or
interact/contradict with conventional drugs.
 Self-prescribing herbal products is risky; it is important to consult the
pharmacist and/or your doctor before taking herbal medicine.
 St. John's wort causes sensitivity to the sun's ultraviolet rays.
 St. John's wort also interferes with the effectiveness of many drugs,
including warfarin (a blood thinner), protease inhibitors for HIV, birth
control pills, and many other medications.
 In addition, St. John's wort must not be taken with anti-depressant
medication.
Is there anything I should watch out for?

 Standardization: means adjusting the herbal drug preparation to a
defined content of a constituent or a group of substances with known
therapeutic activity by adding excipients or by mixing herbal drugs or
herbal drug preparations (e.g. standardized extract from the
European Pharmacopoeia).
 Standardized: contains a certain level of compound(s) known or
believed to indicate a biological activity. Ginkor with its 24% flavone
glycosides and 6% terpene lactones is a classic example.
Standardization of Herbal Medicines

 CAM is mainly in the hands of doctors with MDs in Austria and
Germany , and half or more of the American alternative practitioners
are licensed MDs. In Germany herbs are tightly regulated: half are
prescribed by doctors and covered by health insurance.
 Some professions of CAM, such as chiropractic, have achieved full
regulation in North America and other parts of the world and are
regulated in a manner similar to that governing science-based
medicine.
 In contrast, other approaches may be partially recognized and others
have no regulation at all. Regulation and licensing of CAM varies
widely from country to country!
Regulation of alternative medicine

The Five Domains of Complementary and Alternative Medicine

Spending on CAM??
• In 2009, American spent $33.9 billion for “complementary and
alternative medicine” — everything ranging from acupuncture and
massage therapy to yoga and herbal supplements, with $14.8 billion
of that going toward over-the-counter “natural products” such as
Echinacea and fish oil.
• Americans spend almost a third as much money on herbal
supplements and other alternative medicines as they do on
prescription drugs.
• This represents just 1.5% of overall annual health care costs, which
hover around a $2.2 trillion.
• 38% of adults use some type of alternative or complementary care to
ease their ailments.

Phytotherapy
• Herbal medicines are also referred to as herbal remedies,
phytomedicines, phytotherapeutic agents and
phytopharmaceuticals.
• The use of herbal medicines in an evidence-based approach for
treatment and prevention of disease is known as rational
phytotherapy. This approach to the use of herbal medicines
contrasts with traditional medical herbalism (Ethnomedicine), which
uses herbal medicines in a holistic manner and mainly on the basis
of their empirical and traditional uses.
• Plants have been used medicinally for thousands of years by cultures
all over the world. According to the World Health Organization, 80%
of the world’s population uses plant-based remedies as their primary
form of healthcare.

Control of herbal ingredients in the UK
• Most of the herbal ingredients used in licensed herbal medicines have been
used as traditional remedies for centuries without major safety problems,
and the majority is included in the General Sales List (GSL).
• Potentially hazardous plants such as digitalis, rauwolfia and nux vomica are
specifically controlled under the Medicines Act as prescription–only
medicines, and thus are not available other than via a registered medical
practitioner.
• In addition, certain herbal ingredients are controlled under The Medicines
(Retail Sale and Supply of Herbal Remedies) Order 1977 SI 2130. This Order
(Part I) specifies 25 plants which cannot be supplied except via a pharmacy,
and includes well–known toxic species, such as Areca, Crotalaria, Dryopteris
and Strophanthus. In Part II, the Order specifies plant species, such as
Aconitum, Atropa, Ephedra and Hyoscyamus, which can be supplied by
‘herbal practitioners’, and in Part III defines the dosages and routes of
administration permitted.

Control of herbal ingredients in the USA
• The majority of medicinal herbs and their products are regulated in the USA
as foods or food additives, and most of the regulatory action has been
concerned with safety. In 1990, the FDA reported on over–the–counter
drugs, including herbs. Some herbs (e.g. cascara, senna) were pronounced
safe and effective, but the majority were not. Overall, 250 herbs, primarily
based on their use as food additives, i.e. flavours and fragrances, were
designated GRAS (Generally Regarded As Safe) status; however, this does
not mean that such herbs (e.g. ginger, liquorice) are FDA-approved for
therapeutic purposes.
• In 1994, the Dietary Supplement Health and Education Act (DSHEA) became
law. This Act allows publications, book chapters and scientific reports to
support the sale of dietary supplements. Although medicinal claims cannot
be made for such products, labelling may describe effects on general well–
being.

Comparison of herbalism with rational phytotherapy
• Herbalism
1. Assume that synergy or additive
effects occur between herbs.
2. Holistic prescribing.
3. Preparations mainly formulated
as tinctures.
4. Mainly uses combinations of
herbs.
5. Opposition towards
standardization.
6. Not scientifically evaluated.
• Rational phytotherapy
1. Seek evidence that synergy or
additive effects occur between
herbs.
2. Not holistic.
3. Preparations mainly formulated
as tablets and capsules.
4. Single-herb products used
mainly.
5. Using standardization.
6. Science-based approach.

Conditions grouped by organ/body system
1 Allergy
2 Respiratory System
3 Heart& Vascular Disorders
4 Blood& Circulation
5 Central Nervous System
6 Digestive System
7 Endocrine System
8 Musculoskeletal System
9 Reproductive System
10 Others

Allergy: Allergic Rhinitis
• Allergic rhinitis is an allergic
inflammation of the nasal
airways. It occurs when an
allergen, such as pollen, dust, or
animal dander (particles of shed
skin and hair) is inhaled by an
individual with a sensitized
immune system.
• In such individuals, the allergen triggers the production of the antibody
immunoglobulin E (IgE), which binds to mast cells and basophils resulting in
the release of of inflammatory mediators such as histamine.
• This usually causes sneezing, itchy and watery eyes, swelling and
inflammation of the nasal passages, and an increase in mucus production.
• When caused by pollens of any plants, it is called pollinosis, and, if
specifically caused by grass pollens, it is known as hay fever.

Allergy: Allergic Rhinitis
Inflammation associated with
allergic rhinitis.
• The characteristic symptoms of allergic
rhinitis are: rhinorrhoea (excess nasal
secretion), itching, sneezing, and nasal
congestion and obstruction.
• Hay fever is not a true fever, i.e. it does
not cause a core body temperature in the
fever range of 37.5–38.3 °C. However, it
can cause increased fluctuation in the
core temperature of the sufferer, in
conjunction with inflammation.
• Allergy testing may reveal the specific allergens to which
an individual is sensitive. Skin testing is the most
common method of allergy testing.

Allergy: Treatment of Allergic Rhinitis
• The goal of rhinitis treatment is to prevent or reduce the symptoms
caused by the inflammation of affected tissues. Measures that are
effective include avoiding the allergen.
• Antihistaminics can be taken orally, nasally or as eye drops to control
symptoms such as sneezing, rhinorrhea, itching, and conjunctivitis.
• First generation Antihistaminics such as diphenhydramine have
undesirable side-effects (mainly drowsiness).
• Second- and third-generation antihistamines such as cetirizine and
loratadine are less likely to cause drowsiness.
• Pseudoephedrine is also indicated for nasal congestion with
antihistamines.
• Steroid nasal sprays are effective and safe(!), and may be effective
without oral antihistamines.

• Bromelain Extract: mainly obtained from the stems of pineapples (Ananas
sp.). Bromelain is a mixture of heat-labile proteolytic enzymes (proteases)
together with several other constituents found in smaller quantities.
Bromelain has anti-inflammatory properties and may help suppress
symptoms of sinusitis, and relieve the swelling and inflammation caused by
hay fever.
• Dose: 750-1,000 mg (tablets) daily in divided doses between meals.
• Bromelain is one of the most popular proteases to use for meat tenderizing
(directly sprinkled as powder on the uncooked meat).
• Fatty Acids: γ-linolenic acid (ω-6 fatty acids, found in the oil of evening
primrose and borage seeds) and omega-3 fatty acids (ω-3 fatty acids, found
in the oil of fish, linseed, and walnuts) may relieve allergy symptoms.

• Borage seed oil has one of the highest amounts of γ-linolenic acid of seed
oils (24%) and it has anti-inflammatory and anti-thrombotic effects.
• Quercetin: a flavonols with antioxidant properties and inhibits the
production and release of histamine. 200-400 mg, 3-times a day.
• Quercetin can be found in
apples, berries, and onions
and is associated with the
reduced risk of coronary
heart disease and stroke.
• Vitamin C: Some studies
suggest that vitamin C
plays a role in treating
symptoms of hay fever and
year-round allergic rhinitis

• Evening primrose oil (EPO, Oenothera
biennis oil) is considered to have beneficial
health effects, largely due to its GLA
content. Evening primrose is sometimes
used to treat eczema.
• Most studies evaluating the effectiveness of
EPO used a dose of 1600 mg of
standardized extract (4 capsules) by mouth
twice daily for up to 12 weeks.
• Nettle Root Extract - Nettle Root Extract
(Stinging nettle, Urtica dioica) is proposed
to have antihistamine properties and
recommended to be taken as a freeze dried
preparation well before the start of hay
fever season.

• Echinacea (Echinacea angustifolia/ E. purpurea) Several
studies suggest that Echinacea contains substances that
enhance the activity of the immune system and reduce
inflammation. For these reasons, professional herbalists
may recommend Echinacea to treat allergic rhinitis.
• Goldenseal (Hydrastis canadensis): It is suggested that
berberine, the active ingredient in goldenseal, has
antibacterial and immune-enhancing properties, and many
herbalists include it in herbal remedies for allergic rhinitis.
• Liquorice (Glycyrrhiza glabra) contains anti-inflammatory
triterpenoidal saponins and flavonoids.

Allergy: Sinusitis
• Sinusitis, also known as
rhinosinusitis, is inflammation
of the paranasal sinuses. It
can be due to infection
(Bacterial, viral or fungal),
allergy, or autoimmune
problems.
• Headache/facial pain or
pressure of a dull, constant,
or aching sort over the
affected sinuses is common
with both acute and chronic
stages of sinusitis.

Allergy: Treatment of Sinusitis
• Antibiotics are prescribed if a bacterial infection is present or
suspected
• Decongestants and Nasal steroidal spray
• Surgery

Allergy: Sinusitis
• Bromelain, Quercetin and Vitamin C.
• N-Acetylcysteine (NAC): is an amino
acid derivative that can reduce
inflammation in mucus membranes, via
its direct-antioxidant property and
indirectly as a precursor of glutathione
synthesis.
• It has a mucolytic activity via splitting
the disulfide bonds of mucoproteins
and thus reduces the sputum viscosity.
• It slows down HIV virus replication and
is recommended treatment for AIDS.

Allergy: Sinusitis
• Sinuvil contains, among other constituents, N-ACETYLCYSTEINE,
QUERCETIN, PANAX GINSENG, BROMELAIN, WILD CHERRY, ZINC &
SELENIUM.
• Zinc: Zinc supplementation enhances
immune system activity and protects
against a range of infections including
colds and upper respiratory infections.
• Zinc gluconate products contain the
lowest cadmium levels. Exposure to
high levels of cadmium over a long
time can lead to kidney failure.
• A study showed that elderly patients who received zinc and selenium
had fewer infections than patients who received a placebo.

Respiratory System: Asthma
• Asthma is a disease in which inflammation of the airways restricts airflow.
• Many patients with asthma also have allergies.
Treatment
• Bronchodilators as β2-
adrenergic agonists (e.g.
salbutamol) and theophylline.
• Steroids (such as prednisone)
are needed for acute asthma
attacks.

• Buteyko Breathing Technique is a form of complementary physical
therapy that proposes the use of breathing exercises as a treatment for
asthma as well as other conditions.
• At the core of the Buteyko method is a series of reduced-breathing
exercises that focus on nasal-breathing, breath-holding and relaxation.
https://www.youtube.com/watch?v=fdnTvfooGn8
https://www.youtube.com/watch?v=dtY0AZKJYnU
https://www.youtube.com/watch?v=hx-3dt9L72c

• Dietary modification can influence the severity and incidence of asthma.
The increased incidence of asthma in Western societies may be due to
the consumption of a proinflammatory diet (20- to 25-fold more ω-6
polyunsaturated fatty acids (PUFA) than ω-3 PUFA), which causes the
release of proinflammatory arachidonic acid metabolites (leukotrienes
and prostanoids). Diet with increased ω-3 fatty acids and reduced ω-6
fatty acids protects children against symptoms of asthma.
• pharmaceutical-grade fish oil (omega-3 PUFA) supplementation reduces
airway hyperresponsiveness after exercise, medication use, and
proinflammatory mediator generation in athletes with exercise-induced
bronchoconstriction.

• Adding onion, garlic, pungent spices, and antioxidants (such as foods rich
in vitamin C, vitamin E, flavonoids, and β-carotene) to the diet may help
reduce symptoms of asthma.
• Quercetin and vitamin C.
• Lobelia (Lobelia inflata): contains piperidine alkaloids lobeline and
lobelanine.
• Thyme (Thymus vulgaris): V.O. (thymol), saponins.
• Tr. Benzoin Co. (Benzoin): benzoic and cinnamic acids.
• Ginkgo (Ginkgo biloba).
• Senega (Polygala senega): saponins
• Red Clover (Trifolium pretense): flavonoids and saponins.

• Black seed (Nigella sativa) oil has been traditionally used for centuries for
easing respiratory problems.
• It was rediscovered in Germany in 1995 when the horse of a doctor was
cured of acute asthma from black seed. The doctor was so astounded
that he applied black seed to one of his patients who was also cured. The
anti-inflammatory, anti-spasmodic effects of the black seed oil reduces
the intensity of the asthma symptoms.
• An antispasmodic effect and increase in mucociliary clearance has been
reported for nigellone but not for thymoquinone.
• Asthma may be prevented by the use of black seed oil. The altered
immune response in terms of hypersensitivity is the root cause of asthma.

• Thymoquinone has antioxidant effects and has been shown to protect
against heart, liver and kidney damage in animal studies as well as having
potential anti-cancer effects. It also has analgesic and anticonvulsant
effects in animal models. Thymoquinone and dithymoquinone appear to
inhibit mast cell histamine release in response to certain stimuli.

Respiratory System: Cough
• Cough (Latin: tussis) is a sudden and often repetitively occurring
protective reflex which helps to clear the large breathing passages from
secretions, irritants, foreign particles and microbes.
• Treatment should target the cause; for example, smoking cessation or
discontinuing ACE inhibitors.
• 10-25% of people who take ACE inhibitors suffer from cough as a side
effect.
• As it is a natural protective reflex, suppressing the cough reflex might
have damaging effects, especially if the cough is productive.
• Cough can be non-productive (dry) or productive (when sputum is
coughed up).

Respiratory System: Cough treatment
• Bromelain containing supplements may help suppress cough, reduce
nasal mucus associated with sinusitis. It is often administered with
quercetin. Quercetin has anti-histamine properties and, therefore, may be
helpful if your cough is related to allergies.
• Zinc: Several important studies have revealed that zinc lozenges may
reduce the intensity of the symptoms associated with a cold, particularly
cough.
• Licorice = Liquorice (Glycyrrhiza glabra): It contains triterpenoidal
saponins. Liquorice has long been valued as expectorant, demulcent
(soothing, coating agent) and continues to be used by professional
herbalists today to relieve allergies, bronchitis, colds, and sore throats.
• People with high blood pressure, obesity, diabetes and heart conditions
should avoid licorice.

• Food and Drug Administration believes that foods containing liquorice
and its derivatives (including glycyrrhizin) are safe if not consumed
excessively. No more than 100mg to 200mg of glycyrrhizin per day, the
equivalent of about 70g to 150g of liquorice, should be used.
• Inappropriate use of licorice can produce pseudoaldosteronism, by
inactivating 11-β-hydroxysteroiod-dehydrogenase and by binding to
mineralocorticoid receptors. This is expressed in the form of sodium
retention, potassium loss and suppression of the renin-angiotensin-
aldosterone system.
• Licorice possesses many other therapeutic properties as to potentiate
the action of cortisol, to reduce testosterone synthesis, and, especially in
women, to exert an estrogen-like activity.

• Eucalyptus (Eucalyptus globulus): Eucalyptus oil acts as an expectorant.
It is found in many lozenges, cough syrups, and vapor baths.
• Lobelia
• Peppermint (Mentha piperita) and thyme: Menthol and thymol have
expectorant properties.
• Guava leaves, fennel, and senega: Expectorant
• Ipecachuana: isoquinoline alkaloids cephaline, psychotrine and emetine
(Expectorant)
• Myrrh: Oleo-gum-resin (Expectorant)
• Asafoetida: Oleo-gum-resin (Expectorant)
• Benzoin: Expectorant
• Honey: Expectorant

• Echinacea is used to reduce the symptoms of
cough.
• Garlic (Allium sativum) oil: is often used to
help reduce symptoms of coughs, and
bronchitis.
• Ginger (Zingiber officinale): is believed to
help common cold and flu-like symptoms,
which may include cough.
• Tilia (Tilia cordata) flowers may be
recommended by an herbalist for colds,
cough, or fever.
• Stinging nettle (Urtica dioica): may act as an
expectorant.
• Turmeric (Curcuma longa)

Respiratory System: Common cold
• Marjoram Leaf: Origanum marjorana (V.O.): The plant is traditionally used
to treat respiratory diseases. It is also used to relieve the symptoms of
common cold.
• Astragalus (Astragalus membranaceus): Astragalus has been used
traditionally to enhance the immune system,
• Celery seed (Apium graveolens) (V.O.): Celery seed is used to treat colds
and flus.
• Echinacea is primarily used to shorten the duration of the common cold.
• Eucalyptus
• Garlic oil: In one study, patients who received garlic had significantly
fewer colds than those who received placebo.
• German Chamomile (V.O. and flavonoids): it has been used to treat a
variety of symptoms related to cold including chest and nasal congestion
as well as sore throats.

Respiratory System: Common cold
• Goldenseal (Hydrastis canadensis): contains berberine and hydrastine
alkaloids. Goldenseal is often combined with echinacea in preparations
designed to strengthen the immune system.
• Licorice
• Tilia: Active ingredients in Tilia help promote sweating, which may be
helpful if you have a fever.
• Peppermint
• Siberian ginseng: It may improve the immune system.

Heart& Vascular Disorders: Hypertension
• Hypertension is a condition in which the systolic
blood pressure is at or above 140 mm Hg, or the
diastolic blood pressure is at or above 90 mm Hg,
or both. Currently, hypertension is thought to
affect roughly 1 billion patients worldwide.
• Hypertension is rarely accompanied by any symptoms, and its identification is
usually through screening, or when seeking healthcare for an unrelated
problem.
• Hypertension is classified as either primary (essential) hypertension or
secondary hypertension; about 90–95% of cases are categorized as primary
hypertension which means high blood pressure with no obvious underlying
medical cause.
• Hypertension occurs in approximately 8–10% of pregnancies.
• Hypertensive crisis: Severely elevated blood pressure (equal to or greater
than a systolic 180 or diastolic of 110 mm Hg.

Heart& Vascular Disorders: Hypertension cause
• The genetic basis of hypertension is
still poorly understood; however, it is
believed that hypertension results
from a complex interaction of genes
and environmental factors.
• Several environmental factors as well
as life style influence blood pressure.
• Events in early life (for example low
birth weight, maternal smoking and
lack of breast feeding) act as risk
factors for adult essential
hypertension.
• In most people with primary hypertension, increased resistance to blood flow
(total peripheral resistance) accounts for the high pressure while cardiac
output remains normal.

• Many mechanisms have been
proposed to account for the rise in
peripheral resistance in hypertension.
Most evidence implicates either
disturbances in renal salt and water
handling (particularly abnormalities in
the intrarenal renin-angiotensin
system) and/or abnormalities of the
sympathetic nervous system.
• Endothelial dysfunction and vascular
inflammation may also contribute to
increased peripheral resistance and
vascular damage in hypertension.

Heart& Vascular Disorders: Hypertension TTT
• Medications: Diuretics, Beta-blockers, Calcium-channel blockers. The
American Heart Association estimated the direct and indirect costs of high
blood pressure in 2010 as $76.6 billion.
• Alternative/complementary approaches: Lifestyle changes are recommended
to lower blood pressure, before starting drug therapy. The British
Hypertension Society guidelines for the prevention of hypertension include:
1. maintain normal body weight for adults (e.g. body mass index 20–25 kg/m2)
2. reduce dietary sodium intake to <6 g of sodium chloride or <2.4 g of sodium
per day.
3. Engage in regular aerobic physical activity.
4. limit alcohol consumption to no more than 2-3 units/day.
5. Consume a diet rich in fruit and vegetables.
• Effective lifestyle modification may lower blood pressure as much as an
individual antihypertensive drug. Combinations of two or more lifestyle
modifications can achieve even better results!

• The DASH diet (Dietary Approaches to Stop Hypertension) is a dietary pattern
promoted by the National Heart, Lung, and Blood Institute (USA) to prevent
and control hypertension.
• The DASH diet is rich in fruits, vegetables, whole grains, and low-fat dairy
foods; includes meat, fish, poultry, nuts, and beans; and is limited in sugar-
sweetened foods and beverages, red meat, and added fats.
• In addition to its effect on blood pressure, it is designed to be a well-balanced
approach to eating for the general public (recommended by the United States
Department of Agriculture as one of its ideal eating plans for all Americans).
• DASH reduced systolic blood pressure by 11 mm Hg and diastolic blood
pressure by 6 mm Hg in hypertensive patients.
• The DASH dietary pattern is adjusted based on daily caloric intake ranging
from 1600 to 3100 calories.

• Garlic (Allium sativum): Garlic has long been used for a variety of
cardiovascular conditions, especially hyperlipidemia. Garlic has antioxidant
and hypotensive activities. Garlic increases nitric oxide production, resulting
in smooth muscle relaxation and vasodilatation.
• Hawthorn (Crataegus monogyna): benefit in treating chronic heart failure,
cardiovascular disorders and regulate blood pressure. A professional
herbalist may recommend between 160 and 900 mg of hawthorn leaf and
flower extract per day for six weeks or more.
• Rauwolfia (R. serpentine) roots: The most powerful hypotensive plant.
Reserpine, the purified alkaloid of R. serpentina, was the first potent drug
widely used in the long-term treatment of HTN.
• Red Korean ginseng (Panax ginseng)
• German Chamomile: through its sedative effect
• Punica granatum (Pomegranate; Family: Punicaceae). Pomegranate reduces
the activity of angiotensin converting enzymes (ACE) by about 36%.

• Chronic administration of Pet ether extract (50 mg/kg/day), toluene fraction
(10 mg/kg/day) of ginger rhizome, and Korean ginseng extract (30 mg/kg/day)
significantly reduced the BP in deoxycorticosterone acetate salt-induced
hypertensive rats. Ginger acts to improve blood circulation and relaxes
muscles surrounding blood vessels.
• Triticum aestivum (Family: Gramineae; Common names: Bran, Wheat bran).
Increasing dietary wheat bran intake by 3 to 6 g/day modestly reduces
systolic and diastolic BP.
• Theobroma cacao (Family: Malvaceae; Common names: Chocolate, Cocoa
Butter). Cocoa powder is used for preventing cardiovascular disease.
Flavonoids, contained in chocolate, stimulate formation of nitric oxide,
increase vasodilatation, and reduce endothelial dysfunction.
• Sesamum indicum (Family: Pedaliaceae; Common name: Sesame). Alcoholic
extract of seeds (1–30 mg/kg) caused hypotension in anesthetized rats.

• α-Linolenic acid, an essential fatty acid that appears to be beneficial for the
heart diseases, inflammatory bowel disease, arthritis, and other health
problems. Diet rich in omega-3 fatty acids lower BP significantly in people
with HTN.
• Hibiscus sabdariffa (Family: Malvaceae): The antihypertensive effects of the
crude extract of HS have been attributed to mediation through acetylcholine
and histamine like dependent mechanism through direct vasorelaxant effects.
• A standardized dose of HS (9.6 mg per day) given to 39 patients and
captopril, 50 mg per day, given to the same number of patients did not show
significant difference relative to hypotensive effects.
• Daucus carota (Family: Umbelliferae; Common name: Carrot): Activity-
directed fractionation of aerial parts of D. carota resulted in the isolation of
two coumarin glycosides. Intravenous administration of these compounds
caused a dose-dependent (1–10 mg/kg) fall in arterial BP in rats, likely through
blockade of calcium channels.

• Apium graveolens (Family: Apiaceae; Common name: Celery). In China,
celery was useful in reducing HTN in 14 of 16 patients. The juice was mixed
with equal amount of honey and about 8 ounces were taken orally three times
a day for up to one week. It has also been reported to reduce systolic and
diastolic BP. The difference of BP in human beings before and after treatment
has been found to be significant (P<0.05), indicating that seeds of A.
graveolens can be used as a safe and effective treatment of high BP.

Heart& Vascular Disorders: Varicose Veins
• Varicose Veins are large, twisted veins, usually in
the legs and feet that do not transport blood
effectively. If ignored, serious complications, such
as phlebitis (inflammation of veins), skin ulcers, and
blood clots can occur.
• Veins have pairs of leaflet valves to prevent blood
from flowing backwards. When veins become
varicose, the leaflets of the valves no longer meet
properly, and the valves do not work (valvular
incompetence). This allows blood to flow
backwards and veins enlarge.
• Varicose veins are more common in women than
men, and are linked with heredity. Other factors
include pregnancy, obesity, menopause, aging,
prolonged standing and leg injury.

The symptoms of varicose veins can be controlled with the following:
• Elevating the legs often provides temporary symptomatic relief.
• Regular exercise.
• The wearing of graduated compression stockings with variable pressure
gradients (Class II or III) has been shown to correct the swelling, nutritional
exchange, and improve the microcirculation in legs affected by varicose
veins. Caution should be exercised in their use in patients with concurrent
arterial disease.
• Diosmin/Hesperidine and other flavonoids.
• Anti-inflammatory drugs (e.g. ibuprofen or aspirin
can be used as part of treatment for superficial
thrombophlebitis. Topical gel application, helps in
managing symptoms related to varicose veins
such as inflammation, pain, swelling, itching and
dryness.

• A commonly performed non-surgical treatment for varicose and "spider" leg
veins is sclerotherapy in which a special chemical (sclerosant) is injected into
a varicose vein to damage and scar the inside lining of the vein. This causes
the vein to close. During this procedure, the affected leg is elevated to drain
blood, and the sclerosant is injected into the varicose vein. The procedure
takes 15 to 30 minutes, depending on how many varicose veins are treated
and how big they are. Commonly used as sclerosants include polidocanol,
sodium tetradecyl sulphate, Hypertonic Saline and Glycerin. The salt solution/
sclerosant is injected through a very fine needle directly into the vein.
Polidocanol

Nutrition and Dietary Supplements
• Food rich in dietary fiber in the form of complex carbohydrates (whole grains)
and flavonoids (dark berries, dark leafy greens, garlic, and onions).
• Beneficial nutrient supplements include vitamin C (500 to 1,000 mg three
times per day), vitamin E (200 to 600 IU per day), and zinc (15 to 30 mg per
day).
Herbal drugs
• Butcher's broom (Ruscus aculeatus) standardized extract (9% to 11%
ruscogenin, steroidal saponin) 100 mg three times per day.
• Ruscogenin has strengthening action on the walls of vessels, reducing their
fragility, porosity, and permeability. It is also a powerful vasoconstrictor – the
means to prevent vessels dilation.
• Ruscogenin also inhibits the enzyme elastase, which is involved in the
acceleration of the recycling of the lining of veins. Via inhibition of elastase,
ruscogenin prolongs the life of the lining.

• Horse chestnut (Aesculus hippocastanum) 500 mg three times per day or
standardized Aescin (saponin, 10 mg three times per day).
• Aescin or escin is a mixture of saponins with anti-inflammatory,
vasoconstrictor and vasoprotective effects.
• Gotu kola (Centella asiatica) 1,000 mg two to four times per day, or
standardized extract (asiaticoside 40%, Asiatic acid 30%, madecassoside 1%
to 2%) 60 mg one to two times per day. Gotu kola may help reduce swelling
and improve blood flow.
• Buchu leaves: due to the flavonoid glycoside diosmin.

Blood & Circulation: Anemia
• Anemia: Deficiency in red blood cells or
in haemoglobin (the iron-containing
oxygen-transport metalloprotein in the
red blood cells of almost all vertebrates
and some invertebrates).
• It can also be defined as a lowered
ability of the blood to carry oxygen. It
affects about a quarter of the population
globally.
• Hemoglobin = 35% of the total content of
RBCs.
• The mammalian hemoglobin molecule
can bind up to four oxygen molecules.
Heme

Blood & Circulation: TTT of Anemia
• Vitamin B12, iron (II) and folic acid (vitamin M, vitamin B9).
• Pernicious anemia results in loss of gastric parietal cells, which are
responsible, in part, for the secretion of intrinsic factor, a protein essential for
subsequent absorption of vitamin B12 in the ileum.
• Folate deficiency can lead to macrocytic anemia.
• Dietary supplementation, without determining the specific cause, is not
recommended.
• Dietary sources of iron include meat (liver), beans, green leafy vegetables,
blackstrap molasses and almonds. Leafy vegetables are principal sources of
folic acid. Dietary sources of Vitamin B12 include liver, meats, eggs, tuna, and
cheese.
• Vitamin C: (250 to 500 mg twice a day) to help in absorption of iron (II).
Dietary sources include citrus fruits and juices, tomatoes, broccoli.

• Blackstrap molasses, also known as pregnancy tea (1 tbs. per day in a cup of
hot water), is a good source of iron, B vitamins, and minerals. Blackstrap
molasses is also a very gentle laxative.
• Blackstrap, is the dark, viscous molasses remaining after maximum extraction
of sugar from raw sugar cane.
• It contains significant amounts of vitamin B6 and minerals, including calcium,
magnesium, iron, and manganese; one tablespoon provides up to 20% of the
recommended daily value of each of those nutrients. Blackstrap is also a
good source of potassium.

1. Blackstrap molasses, also known as pregnancy tea (1 tbs. per day in a cup of
hot water), is a good source of iron, B vitamins, and minerals. Blackstrap
molasses is also a very gentle laxative.
• Blackstrap, is the dark, viscous molasses remaining after maximum extraction
of sugar from raw sugar cane.
• It contains significant amounts of vitamin B6 and minerals, including calcium,
magnesium, iron, and manganese; one tablespoon provides up to 20% of the
recommended daily value of each of those nutrients. Blackstrap is also a
good source of potassium.
2. Spirulina (blue-green Algae) that is rich in protein, vitamins, minerals, and
antioxidants.
3. Alfalfa (Medicago sativa), F.Fabaceae. Alfalfa is high in protein, calcium and
other minerals, vitamins in the B group, vitamin C, vitamin D, vitamin E, and
vitamin K.
• Alfalfa, like other leguminous crops, is a known source of phytoestrogens.

Blood & Circulation: Hypercholesterolemia
• Hypercholesterolemia is a high level of cholesterol in the blood that can cause
plaque to form and build up leading to blockages in the arteries
(arteriosclerosis), increasing the risk for heart attack, stroke, circulation
problems, and death.
• The normal range for total blood cholesterol is between 140 and 200 mg per
decilitre (mg/dL) of blood. Levels between 200 and 240 mg/dL indicate
moderate risk, and levels surpassing 240 mg/dL indicate high risk. High
cholesterol is characterized by elevated levels of LDL cholesterol (low density
lipoproteins), normal or low levels of HDL cholesterol (high density
lipoproteins), and normal or elevated levels of triglycerides.
• Risk factors: Obesity , physical inactivity ,
stress, smoking, underactive thyroid and
diabetes, and genetic predisposition.
• Preventive Care: Maintaining a healthy body
weight through increased physical activity
and appropriate caloric intake is important.

• Diet: Reduce the amounts of saturated fat and cholesterol consumed each
day. Increase daily consumption of fruits, vegetables, fish, and whole grains.
Supplement the diet with other protective components such as fiber.
• Whole grains are cereal grains that contain cereal germ, endosperm,
and bran, in contrast to refined grains, which retain only the endosperm.
Common whole grains include: Wheat, Oat, Barley, Maize and Brown rice.
• Dietary sucrose and fructose can raise LDL cholesterol levels in the blood.

Dietary guidelines for reducing cholesterol and fat consumption
1. Fish: contains beneficial omega-3 fatty acids, which help to reduce
inflammation and LDL cholesterol levels, and raise HDL cholesterol. Salmon
and mackerel are particularly good sources.
2. Garlic: helps reduce cholesterol, thins the blood, and has antioxidant
properties.
3. Phytosterols and/or phytostanols reported an average of 9% lowering of LDL-
cholesterol.
4. Nuts (almonds and walnuts) help lower cholesterol levels. Nuts contain fibre
and nutrients such as vitamin E, α-linolenic acid, magnesium and potassium,
which are important for heart health. Although nuts are high in calories, some
studies have found that increasing nut consumption by several hundred
calories per day does not cause weight gain.
5. Olive oil: Limited and not conclusive scientific evidence suggests that eating
about 2 tbsp. (23 g) of olive oil daily may reduce the risk of coronary heart
disease due to the monounsaturated fat in olive oil.

6. Soluble fiber, which is found in oats, flaxseed, beans, psyllium, and fruits
(avocado), helps to lower cholesterol levels. Insoluble fiber, which is found in
whole grains, vegetables, and fruits, does not lower cholesterol, but studies
have shown that it helps protect against heart disease. Aim for a total of 35 g
of fiber daily.
7. Soy products (soybeans and soy protein powder) can help lower cholesterol
and triglycerides. Lunasin, a peptide found in soy, has been the subject of
research focusing on cancer, cholesterol and cardiovascular diseases and
inflammation. Soybean oil contains a significant amount of the omega-3 fatty
acid α-linolenic acid. FDA approved soy as an official cholesterol-lowering
food, along with other heart and health benefits. Soybeans also contain
isoflavonoids (phytoestrogens) and antioxidants.
8. Yogurt and fermented milk products have been shown to lower cholesterol
levels.
9. Oat bran: rich in soluble fiber (β-glucan) that has been shown to lower
cholesterol levels. A typical dose of oat bran is 5–10 g taken with each meal.
The recommended intake is 10–15 g of β-glucan per day.

• Bulk producers as Psyllium, Foenugreek,
Linseed, produce a sense of fullness, as
they contain dietary fibers, Slow the
movement of food from the stomach to the
intestines, Decrease cholesterol &
triglycerides, Rich in vitamins and minerals.
10.Green Tea (Camellia sinensis): Green tea has antioxidant effect. It has also
demonstrated the ability to lower total cholesterol and raise HDL cholesterol
in both animals and people. Results from the study suggest that the catechins
in green tea may block intestinal absorption of cholesterol and promote its
excretion from the body.
11.Thermogenic agents (e.g. Capsicum and Piper): Although they are appetizers,
they increase basal metabolic rate or stimulate thermogenesis.
12.Non-Calorie Sweeteners: e.g. Glycyrrhizin is 50 times sweeter than sucrose.

Dietary Fiber: Insoluble vs. Soluble
• Dietary fiber, the indigestible cell wall
component of plant materials, plays an
important role in human health.
• Soluble fiber: The edible parts of
plants or similar carbohydrates
resistant to digestion and absorption in
the human small intestine with
complete or partial fermentation in the
large intestine.
• When soluble fiber is fermented, short-chain fatty acids (SCFA) are produced.
SCFAs are involved in numerous physiological processes promoting health as:
1. Suppress cholesterol synthesis by the liver and reduce blood levels of LDL
cholesterol and triglycerides responsible for atherosclerosis.
2. lower colonic pH (i.e., raises the acidity level in the colon) which protects the
lining from formation of colonic polyps and increases absorption of dietary
minerals.

Dietary Fiber: Insoluble vs. Soluble
• The term "fiber" is misleading, since many types of so-called dietary fiber are
not actually fibrous.
• Soluble fiber attracts water and turns to gel during digestion.
• Insoluble fiber, does not dissolve in water, is metabolically inert and provides
bulking, or it can be prebiotic and metabolically ferment in the large intestine.
Bulking fibers absorb water as they move through the digestive system, easing
defecation.

Dietary Fiber: Soluble and Insoluble
• Current recommendations from the United States National Academy of
Sciences suggest that adults should consume 20–35 grams of dietary fiber
per day.
• Dietary fibers have 3 main mechanisms: bulking, viscosity and fermentation.
1. Increases food volume without increasing caloric content to the same extent
as digestible carbohydrates, providing satiety which may reduce appetite.
2. Attracts water and forms a viscous gel during digestion, slowing the
emptying of the stomach and intestinal transit, shielding carbohydrates from
enzymes, and delaying absorption of glucose, which lowers variance in
blood sugar levels.
3. Lowers total and LDL cholesterol, which may reduce the risk of
cardiovascular disease.
4. Regulates blood sugar, which may reduce glucose and insulin levels in
diabetic patients and may lower risk of diabetes.
5. Speeds the passage of foods through the digestive system, which facilitates
regular defecation. As it adds bulk to the stool, it alleviates constipation.
6. Balances intestinal pH, which may reduce risk of colorectal cancer.

Central Nervous System: Dementia and Alzheimer's Disease
• Dementia, a loss of brain function, can occur with a variety of
diseases. One of these is Alzheimer's Disease (AD), which affects
memory, thinking and behavior and gradually gets worse as the
disease progresses.
• AD is a progressive neurodegenerative disorder that causes
irreversible damage to brain cells and loss of brain tissue leading to
dementia and ultimately death.
• It is characterized by formation of amyloid plaques and neurofibrillary
tangles in the brain. Currently, it is primarily diagnosed by exclusion
of other known causes of dementia.
• You are more likely to get AD if you are old, have a relative with AD,
have a history of head trauma, chronic high blood pressure, or have a
genetic predisposition. Women tend to be at higher risk.

• There are two types of AD:
1. Early onset where symptoms become evident before the age of 60.
Several genes have been identified with Early onset and, as expected,
this tends to run in certain families.
2. Late onset (most common) occurs in people older than 60.
• In both types, genes and environmental factors seem to play a role.
• Alzheimer's presents some challenging issues such as misplacing things,
personality changes, getting lost in familiar settings, mood changes,
difficulty recalling the names of familiar objects, or finding it challenging
to accomplish tasks that used to be easy.
• As the disease progresses, the individual may experience hallucinations,
violent behavior, forgetting current events, poor judgment, depression,
wakefulness at night, confusion in communication or forgetting ones' life
history.

• Once the disease reaches a severe stage, family members are not
recognized, and it becomes very difficult to perform basic activities in
daily life.
• The only way to unambiguously positively diagnose AD is to assess a
brain tissue sample after death, looking for neurofibrillary tangles, and
senile plaques.
• Calcium-dependent potassium channels have been found to be implicated
with AD. Abnormalities of potassium (K+) channel function have been
reported in cultured cells in AD.

 Alzheimer's disease leads
to nerve cell death and
tissue loss throughout the
brain. Over time, the brain
shrinks dramatically,
affecting nearly all its
functions.
 These images show:
1. A brain without the
disease.
2. A brain with advanced AD.
3. How the two brains
compare.
1 2
3

Illustration of how Alzheimer's
Disease spreads through the
brain as the disease
progresses.
• Beta-amyloid comes from a larger protein found in the
fatty membrane surrounding nerve cells.

• The brains of AD patients have a buildup of two types of proteins.
1. Clumps of abnormal masses called plaques, made of beta-amyloid
protein. These plaques build up between neurons and may stop them
from communicating with each other.
2. Inside nerve cells are tangles, made of twisted tau protein. The brain
needs tau protein to function, but in AD the protein gets twisted,
which may cause damage to brain cells.
• Amyloid beta peptides stick together as groups of protein aggregates
known as amyloid plaques. These plaques are commonly found in the
brains of AD patients, as well as those with other kinds of dementia
disorders.

Role of tau proteins
• Abnormalities in tau in the brain cause amyloid proteins to
accumulate as sticky plaque aggregates inside neurons.
• While the cells attempt to force these protein clumps out, any amyloid
proteins that remain in the cell, along with any tau proteins that are
not functioning, become responsible for cell death.
• Malfunctioning tau proteins prevent brain cells from clearing out toxic
waste and lead to amyloid plaque build-up.

Diagnosis of Alzheimer's Disease
• Apamin is an 18 amino acid cyclic
peptide neurotoxin found in apitoxin
(bee venom). Dry bee venom consists
for 2-3% of apamin.
• One method for early diagnosis of
Alzheimer’s disease uses human blood
platelets. The presence or absence of
functioning calcium-dependent
potassium channels in blood platelets
are determined by employing
potassium channel blockers such as
apamin, the absence of functioning
calcium-dependent potassium
channels indicates a positive diagnosis
for Alzheimer's disease.

Drug TTT of Alzheimer's Disease
• Acetylcholinesterase inhibitors: Reduction in the activity of the
cholinergic neurons is a well-known feature of AD.
• Acetylcholinesterase inhibitors (e.g. Donepezil, Tacrine,
Rivastigmine) are employed to reduce the rate at which acetylcholine
(ACh) is broken down, thereby increasing the concentration of ACh in
the brain and combating the loss of ACh caused by the reduction in
the activity of cholinergic neurons.
Memantine
• N-Methyl-D-aspartate receptor antagonists:
Memantine has been shown to be moderately
efficacious in the treatment of moderate to
severe AD.

Drug TTT of Alzheimer's Disease
• Solanezumab is a monoclonal antibody, being investigated by Eli Lilly
as a neuroprotector for patients with AD, which binds to the amyloid-β
peptides that make up the protein plaques seen in the brains of
people with the disease.
• Bexarotene reduced amyloid plaque and improved mental functioning
in a small sample of mice engineered to exhibit Alzheimer's-like
symptoms.
• Drugs being used in treatment of cognitive impairment and dementia
have a very limited therapeutic value, suggesting the necessity to find
new strategies to prevent/ slow down the progression of dementia.
Bexarotene

TTT of Alzheimer's Disease: Life style and Diet
• Cardiovascular risk factors: hypercholesterolaemia, hypertension,
diabetes, and smoking, are associated with a higher risk of onset and
course of AD.
• People who eat a healthy diet have a lower risk of AD. Diet high in
saturated fats and simple carbohydrates lead to a higher risk of AD.
• Long-term usage of non-steroidal anti-inflammatory drugs (NSAIDs) is
associated with a reduced likelihood of developing AD. NSAIDs can
reduce inflammation related to amyloid plaques.
• People who engage in intellectual activities such as reading,
completing crossword puzzles, playing musical instruments, or regular
social interaction show a reduced risk for AD.

• Calming music may reduce restlessness, boost brain chemicals, and
improve behavior. Relaxation training and other exercises that require
focused attention may help boost social interaction and make it easier
to do tasks.
• The Safe Return Program: uses identification bracelets, wallet cards,
and clothing labels for people with AD.
• People with AD may need help with their diet. They often forget to eat
and drink and can get dehydrated.
• Eat antioxidant foods, including fruits (such as blueberries, cherries,
and tomatoes) and vegetables. Eat foods high in B-vitamins and
calcium, such as almonds, beans, whole grains, dark leafy greens
(such as spinach).

• Eat more high-fiber foods, including beans, oats, and root vegetables
(such as potatoes). Avoid refined foods (e.g. white breads, pastas, and
esp. sugar).
• Eat fewer red meats and more lean meats and cold-water fish. Use
healthy oils in foods, such as olive oil. Reduce or eliminate trans-fats,
found in commercially baked goods such as cookies, crackers, cakes,
French fries, onion rings, donuts, processed foods, and margarine.
• Don’t smoke. Drink 6 - 8 glasses of filtered water daily. Exercise at
least 30 minutes daily, 5 days a week.

TTT of Alzheimer's Disease: Alternative medicinal approaches
• Phosphatidylserine (Pps) is an important phospholipid membrane
component.
• It may raise levels of brain chemicals that deal with memory,
according to several studies.
• It may work best in people with mild AD.
• Consumption of Pps may reduce the risk of dementia and cognitive
dysfunction in the elderly.
• Bovine brain contains 713 mg Pps/100 g.
• Do not take Pps if you are taking blood thinners such as warfarin or
aspirin. Use caution if taking it with ginkgo.

• Caffeine, flavonoids and generally antioxidants (e.g. vitamin E and coenzyme
Q10) may decrease the risk of AD.
• Zinc (30 - 50 mg per day) is often low in elderly people, and may help
improve memory.
• Ginkgo (Ginkgo biloba) shows some evidence for treating early AD. The
pharmacological actions of G. biloba extracts are well documented and
include anti-apoptosis, anti-inflammatory effects, neuroprotection,
anxiolysis, MAO-inhibitory effects, and antioxidant effects.
• Huperzine A, an alkaloidal constituent of Huperzia serrata, may improve
memory in AD.
Huperzine A
• Huperzine A is a potent and selective AChE
inhibitor. It may slow your heart rate and can
interact with many medications. Do not take
huperzine A if you have a liver disease or if you are
about to have anesthesia.

• American ginseng (Panax quinquefolium) improves blood flow to the
brain.
• Lemon balm (Melissa officinalis) helped improve mental function in
people with mild-to-moderate AD. Lemon balm may act like a mild
sedative.
• vincamine (isolated from Vinca minor) and its synthetic derivative
vinpocetine increase cerebral blood flow, reduce cerebral
insufficiency due to ischaemia and are associated with improvement
in short-term memory.
• Vinca-derived alkaloids stimulate
cerebral metabolism, modulate
neurotransmitter release and are
neuroprotective in nature.
vinpocetine

• Several cannabinoids (e.g. cannabidiol) occurring in Cannabis sativa
and some synthetic derivatives are neuroprotective in nature.
• Cannabidiol also inhibits hyperphosphorylation of tau in neuronal
cells, and it is antipsychotic and anxiolytic.
Cannabidiol
• A lower prevalence of AD in some
populations is associated with a curcumin-
rich diet, and improved cognitive function
has been linked with consumption of curry, a
food that frequently consists of turmeric
(Curcuma longa), a source of curcumin
(antioxidant). Curcumin

• S-adenosylmethionine (SAM): Brain SAM levels
are severely decreased in AD. SAM can exert a
direct effect on glutathione S-transferase (GST)
activity.
• AD is accompanied by reduced GST activity,
diminished SAM, and increased S-adenosyl
homocysteine (SAH), the downstream metabolic
product resulting from SAM-mediated trans-
methylation reactions. SAM supplementation
improves cognitive ability and reduces amyloid
production. These findings underscore the
critical role of SAM as a neuroprotective dietary
supplement in AD. B vitamin deficiency could
induce hyper-homocysteinemia. SAM

• Dietary omega-3 PUFA, SAM and B vitamin supplementation is
recommended for AD patients.
• β-carotene and Vitamin A: The levels of vitamin A and its precursor, β-
carotene, lower in AD compared to healthy individuals.
• Vitamin B9 (Folate) and Vitamin B12: Decreased levels of both folate
and vitamin B12 have been found in people with AD.
• Dietary omega-3 PUFA, SAM and B vitamin supplementation is
recommended for AD patients.

• Acupuncture may improve memory and daily living
skills in people with AD.
• Several studies have found compelling evidence that
certain aromatherapy oils have a positive effect on the
mood, behavior, and even on the cognitive functioning
of people with dementia.
• Bright lights have been found to be beneficial as a
treatment for sleep disturbances associated with
dementia. In bright light therapy, a person sits in front
of a light box that provides about 30 times more light
than the average office light, for a set amount of time
each day. the light/dark cycle and other environmental
stimuli help maintain the circadian rhythm so that it
stays synchronous with the 24-hour day.
SharpMind™ Ginkgo, L-
Dopa, Phosphatidylserine,
Huperzine A, Vinpocetine
& more

Conditions grouped by organ/body system
1 Allergy
2 Respiratory System
3 Heart& Vascular Disorders
4 Blood& Circulation
5 Central Nervous System
6 Digestive System
7 Endocrine System: Dr. Lourine
8 Musculoskeletal System
9 Reproductive System
10 Others

Digestive System: Constipation
Constipation can be caused by a low fiber diet, low liquid intake, or dieting.
Nutrition and Dietary Supplements:
• The main treatment of constipation involves the increased intake of water
and fiber (either dietary or as supplements).
• Fiber relieves constipation by adding bulk to stool and speeding its transit
through the digestive tract. Psyllium (mucilage) is an example of a soluble
fiber used standardly as a laxative.
• Castor oil is used orally to clean out the intestines 6-12 hours before a
bowel examination/surgery. Castor oil is known as a stimulant laxative. It
works by increasing the movement of the intestines, helping the stool to
come out.
• Stimulant laxatives, contact laxatives, act on the
intestinal mucosa or nerve plexus, altering water
and electrolyte secretion.

Digestive System: Constipation
• They also stimulate peristaltic action and can be dangerous under certain
circumstances. They are the most powerful among laxatives and should
be used with care.
• Almond oil has a mild laxative effect. Consume 2 tbsp. of almond oil daily
to relieve constipation. Almond oil also has been found to lower LDL levels
while raising HDL levels.
• Aloe (Aloe vera/Aloe barbadensis/Aloe ferox): Aloe juice contains
anthraquinones. Although Aloe latex is a powerful laxative, it is not used
frequently because it can cause painful cramping. Other gentler, herbal
laxatives (such as Cascara and Senna) are generally recommended first.
• Flaxseed (Linum usitatissimum) : F. O. and mucilage.
• Rhubarb (Rheum palmatum): anthraquinones.
• Foenugreek: mucilage.
• The routine use of laxatives is discouraged.

Digestive System: Diarrhea
• Diarrhea is the condition of having at least three loose or liquid bowel
movements each day. It often lasts for a few days and can result in
dehydration due to fluid loss.
• The most common cause is an infection of the intestines due to either a
virus, bacteria, or parasite; a condition known as gastroenteritis. These
infections are often acquired from food or water that has been
contaminated by stool, or directly from another person who is infected.
• Short duration bloody diarrhea is known as dysentery.
• Prevention of infectious diarrhea is by improved sanitation, clean drinking
water, and hand washing with soap.
• Oral rehydration solution, which is clean water with modest amounts of
salts and sugar, is the treatment of choice. Zinc tablets are also
recommended. Probiotics reduce the duration of symptoms.

Digestive System: Diarrhea
• Bile acid sequestrants such as cholestyramine can be effective in chronic
diarrhea due to bile acid malabsorption.
• Avoid chocolate, dairy products , strong spices.
• The following are recommended: Rice or barley water, fresh vegetable
juices (especially carrot and celery).
• Swelling reducers: quercetin (250 to 500 mg two to four times per day)
and chamomile.
• Infection fighters: goldenseal (250 to 500 mg three times per day) and
licorice root (unless you have high blood pressure).
• Antidiarrheal herbs: Herbs containing tannins as Tea, Coffee, Hamamilis,
and Galls.
• Antispasmodic herbs: especially those containing atropine and
hyoscyamine.

Prebiotics
• Prebiotics is a general term that refers to chemicals that induce the
growth and/or activity of commensal microorganisms (mainly healthy
bacteria = Probiotics) that contribute to the well-being of their host. The
most common example is in the gastrointestinal tract, where prebiotics
can alter the composition of organisms in the gut microbiome.
• Certain hand moisturizers have been proposed to act as prebiotics to
improve the activity and/or composition of the skin microbiota.
• prebiotics are typically non-digestible fiber compounds that pass
undigested through the upper part of the gastrointestinal tract and
stimulate the growth and/or activity of advantageous bacteria that
colonize the large bowel by acting as substrate for them.
• Like probiotics, prebiotics are conceptually intermediate between foods
and drugs.

Live probiotic cultures
are available in
fermented dairy
products and probiotic
fortified foods. However,
tablets, capsules,
powders and sachets
containing the bacteria
in freeze dried form are
also available.

Probiotics ≠ Antibiotics
• Probiotics are microorganisms that
are believed to provide health
benefits when consumed. They are
found naturally in diet, but deplete
over time with age, stress and poor
diet.
• They aid digestion of food, protect
us from certain invasive pathogens,
can produce some vitamins (vitamin
B12, folate, vitamin K) and increase
our immune response.
• Probiotics and prebiotics, together, exert an immunomodulatory role on the
epithelial barrier of gut mucosae.
• Probiotics ability to produce conjugated linoleic acid (CLA) is an additive
health benefit property for its known role in colon cancer mitigation.

Probiotics ≠ Antibiotics
• Probiotics are also useful in the treatment of
(1) antibiotic-associated diarrhea; (2)
Lactose intolerance; (3) Irritable bowel
syndrome and colitis.

Digestive System: Gallbladder Disease
• Gallbladder disease is swelling of the gallbladder, a pear-shaped organ
under the liver that secretes bile, a fluid that helps with digestion.
Gallbladder disease often occurs with gallstones. Some drugs can
dissolve stones, avoiding the need for surgery.
• In people with recurrent gallstones, surgery may be considered. Some
medication, such as Ursodeoxycholic acid (oral bile acid), and ultrasound
to break down the stones may also be used.
• What Causes Gallstones? The bile stored in the
gallbladder contains water, bile salts, cholesterol,
fats, proteins, and bilirubin. Bile salts break up
the fat that is consumed in our food. Gallstones
generally form because the bile is saturated with
either cholesterol or bilirubin.

Types of Gallstones:
• There are two types of gallstones: cholesterol stones and pigment stones.
• Cholesterol stones (hardened cholesterol, yellowish-green in color) are
the most common type of gallstone to develop, occurring in approximately
80% of patients with gallstones.
• Pigment stones are made of bilirubin, and are are usually small and dark
in color.
• Ursodeoxycholic acid reduces cholesterol absorption and is used to
dissolve (cholesterol) gallstones in patients who want an alternative to
surgery.
Ursodeoxycholic acid

Nutrition and Dietary Supplements:
• Decrease total fat intake, especially saturated fats (meat and dairy
products).
• Eliminate food allergens. Eggs, in particular, may irritate the gallbladder.
• Eat more fiber. Consider fiber supplements such as flaxmeal (1 tsp. one to
three times per day). Combine 1 heaping tsp. of flaxmeal in 8 oz. of apple
juice for a drink high in fiber and pectin.
• Choline (1,000 mg per day) and lipase (10,000 NF units with meals)
stimulate gallbladder function. Choline supplementation can be used in
the treatment of liver disorders, hepatitis, glaucoma, atherosclerosis,
Alzheimer's disease, bipolar disorder and possibly other neurological
disorders.
• Vitamin E (400 to 800 IU/day) and vitamin C (1,000 mg
two to three times per day) promote bile production.

Herbal drugs:
• Choleretic herbs stimulate bile production and increase bile solubility.
• Especially useful are milk thistle (Silybum marianum), dandelion root
(Taraxacum officinale), and turmeric (Curcuma longa). Use these herbs
singly or in combination as a tea or tincture (15 to 20 drops), two to three
times per day before meals.
• Sodium curcuminate, a salt of curcumin, also exerts choleretic effects by
increasing biliary excretion of bile salts, cholesterol, and bilirubin, as well
as increasing bile solubility.
• Enteric-coated peppermint oil (Mentha piperita) may help dissolve stones
(0.2 to 0.4 ml three times a day between meals).

Digestive System: Liver Cirrhosis
• Cirrhosis is the damage of liver cells and their gradual replacement with
scar tissue that impairs blood flow through the liver causing hepatocyte
death and loss of liver function. Hepatic fibrosis occurs in response to
liver damage.
• Cirrhosis is most commonly caused by alcoholism, hepatitis B and
hepatitis C, and fatty liver disease, but has many other possible causes.
 Medications
• Antibiotics: for infected ascites (peritonitis)
• Beta-blockers: typically propranolol or nadolol, reduce the heart rate and
can lower the pressure in veins going to the liver.
• Diuretics: as spironolactone.
• Lactulose: reduces toxic levels of ammonia that cause hepatic
encephalopathy, which can result in disturbances in consciousness or
deep coma.

Digestive System: Ascites
• Ascites (fluid retention in the abdominal cavity) is the most common
complication of cirrhosis.
• Ascitic fluid can have many sources such as liver disease,
cancers, congestive heart failure, or kidney failure. Approximately 80% of
the ascites cases are thought to be due to cirrhosis.
• It is associated with a poor quality of life, increased risk of infection, and
a poor long-term outcome.

Digestive System: Hepatic encephalopathy
• Hepatic encephalopathy is the confusion, altered level of consciousness,
and coma that takes place as a result of liver failure. In advanced stages,
it is called hepatic coma . It may ultimately lead to death.
• It is caused by accumulation in the bloodstream of toxic substances that
are normally removed by the liver.
• Ammonia levels in blood may assist in the diagnosis of hepatic
encephalopathy.
• Hepatic encephalopathy is reversible with treatment. This relies on
suppressing the production of the toxic substances in the intestine and is
most commonly done with the laxative lactulose or with non-absorbable
antibiotics. In addition, the treatment of any underlying condition may
improve the symptoms.

• Antioxidants
• Betaine: may help protect against fatty deposits in the liver, which can
occur from chronic alcohol use, protein malnutrition, obesity, poorly
controlled diabetes, and other causes.
• Carnitine: Carnitine is a substance required for the transport of fatty
acids within the mitochondria during the breakdown of lipids for the
generation of metabolic energy.
Betaine
Carnitine
• N-acetyl cysteine
• ω-6 fatty acids (gamma-linolenic acid, GLA): GLA found in
evening primrose oil (EPO) and borage seed oil, may help
lessen cravings for alcohol and prevent liver damage.
• S-adenosylmethionine (SAM): Preliminary research suggests that SAM may
provide protection against liver damage and scarring and may improve
survival rates in people with cirrhosis due to alcohol abuse.

Herbal drugs
• Green Tea (Camellia sinensis): Drinking 10 cups of green tea per day is
likely to protect against disorders of the liver.
• Licorice root: Some preliminary data suggests that taking glycyrrhizin in
combination with cysteine and glycerine may prove useful for helping
reduce the risk of cirrhosis if you have hepatits C.
• Milk thistle (Silybum marianum): Standardized to 70 - 80% silymarin (dose
= 200-400 mg/day).
• Active substances in milk thistle (particularly the flavonoid silymarin)
protect the liver from damage caused by viruses, toxins, alcohol, and
certain drugs such as acetaminophen.
• Milk thistle improves liver function in people with mild liver disease but is
less effective for those with severe liver disease such as cirrhosis.

• Silibinin is the major active constituent of silymarin, a standardized
extract of the milk thistle seeds, containing a mixture of flavonolignans
consisting of silibinin, isosilibinin, silicristin, silidianin and others.
Silibinin
Mechanisms of action:
• Outer hepatocyte cell membrane changes induced preventing toxins from
entering the cells.
• Stimulates nucleolar polymerase A which leads to increased protein synthesis
leading to liver regeneration via the formation of new hepatocytes.
• Decreased biliary cholesterol, increase bile excretion, increase bilirubin
excretion.
• Silibinin has hepatoprotective
(antihepatotoxic) properties, in vitro anti-
cancer effects against a variet of cancers
(e.g. prostate, breast, colon and lung
carcinoma cells).

• Turmeric (Curcuma longa): Animal studies provide evidence that turmeric
may protect the liver from a number of damaging substances such as
carbon tetrachloride and acetaminophen.
• Turmeric accomplishes this, in part, by helping to clear such toxins from
the body and by protecting the liver from damage.
• Ginger (Zingiber officinale)
• Celery Seed (Apium graveolens): may have activity to help protect the
liver from damaging agents such as acetaminophen.
• Dandelion (Taraxacum officinale): Dandelion is a natural diuretic.

Digestive System: Viral Hepatitis
• Hepatitis is a serious disorder in which liver cells become inflamed. The
inflammation most occurs because of a virus. Viral hepatitis usually
appears as type A, B, or C. It can also be caused by an overactive immune
system, and from drugs, alcoholism, chemicals, and environmental toxins.
• Type A, the most common form of viral hepatitis, is transmitted by
contaminated food or water, or contact with a hepatitis A patient. Unlike
hepatitis types B and C, there is no "carrier" state. The hepatitis A or B
vaccines are effective for prevention. No vaccine against hepatitis C is
available.
• Hepatitis types B and C affect people of all ages transmitted through blood
or sexual intercourse with infected person. An estimated 150–200 million
people worldwide are infected with hepatitis C.
• Many illnesses and conditions can cause hepatitis, but certain viruses
cause about half of all hepatitis in people. There are several types of
hepatitis viruses including types A,B, C, D, E, and possibly G.

• Those at risk for viral hepatitis include workers in the health care
profession, people with multiple sexual partners, and intravenous drug
abusers. Blood transfusion is a rare cause of viral hepatitis.
• All hepatitis viruses can cause acute hepatitis.
• Viral hepatitis types B and C can cause chronic hepatitis.
• Symptoms of acute viral hepatitis include fatigue, flu-like symptoms, dark
urine, light-colored stool, fever, and jaundice; however, acute viral
hepatitis may occur with minimal symptoms that go unrecognized.

Medications
• Interferons – this group of medications are natural proteins that activate
immune functions in the body and have anti-viral properties.
• Corticosteroids – may be used in the early stages of chronic hepatitis to
enhance the effects of interferon.
• Nucleoside Analogues– this class of drugs, including lamivudine and
ribavirin, are used to stop replication of the virus.
• These agents can be used against hepatitis B virus, hepatitis C
virus, herpes simplex, and HIV. Once they are phosphorylated, they work
as antimetabolites by being similar enough to nucleotides to be
incorporated into growing DNA strands; but they act as chain terminators
and stop viral DNA Polymerase. They are not specific to viral DNA and
also affect mitochondrial DNA. Because of this they have side effects
such as bone marrow suppression.

Herbal drugs:
• Milk thistle (Silybum marianum)
• Licorice root (Glycyrrhiza glabra): In Japan, glycyrrhizin injections have
been used as a therapeutic drug for chronic hepatitis since 1979. In one
study, Japanese hepatitis C patients who received intravenous treatment
with glycyrrhizin, cysteine, and glycine for an average of 10 years were
significantly less likely to develop liver cancer and cirrhosis than those who
received placebo. In a second study of 57 patients with hepatitis C,
glycyrrhizin significantly improved liver function after only one month.
These effects diminished after glycyrrhizin treatment was discontinued.
• Green tea (Camellia sinensis): Catechin may help treat viral hepatitis.

• Turmeric (Curcuma longa): in animal studies, turmeric has been shown to
have a protective effect on the liver.
• C. longa possesses antioxidant, anti-tumor, antimicrobial, anti-inflammatory,
wound healing, and gastroprotective activities. The curcuminoid and the
sesquiterpene fractions of C. longa have hepatoprotective activities.
• Turmeric has been found to have a hepatoprotective characteristic similar
to that of silymarin.
• Turmeric hepatoprotective effect is mainly a result of its antioxidant
properties, as well as its ability to decrease the formation of pro-
inflammatory cytokines.
• Astragalus (Astragalus membranaceus): This herb is also used for its
immune enhancing properties, especially for the prevention and treatment
of the common cold and chronic hepatitis.

Alternative medicine lectures by Dr. Refaat Hamed

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