herbal medicine

Got Sleep? You may want to consider valerian

Posted by on Sep 2, 2011 in aging, herbal medicine, sleep disturbance | 2 comments

I was out the other day with a few friends and one of them mentioned to me that she was not sleeping well, mainly due to the start of night sweats. She asked me what my secret was. To be entirely honest, I laughed; while I’ve managed to shut down just about every other symptom associated with perimenopause, a full night’s sleep continues to elude me. Still, ever the optimist when it comes to alternative strategies, I pointed her to a few potential interventions that had some strong evidence backing their use for night sweats and symptoms in general, which by default, may help sleep issues.

Ironically, a newly published study in the journal Menopause focuses on valerian and its potential use for insomnia during menopause. A bit more about valerian:

  • Valerian is a perennial that is native to Europe and Asia but is grown in North America. It is well known for its sedative properties and was used by the Greeks and Romans as early as the second century AD.
  • In modern times, valerian has been used for insomnia and other sleep disorders. It has a GRAS (generally recognized as safe) designation by the FDA and is prescribed as a sedative in Germany under Commission E approval.
  • Valerian, which comes most commonly in tablet, extract (tincture) and tea forms, is reportedly among the eight most widely used herbal supplements in America, and data from 2002 suggest that approximately 2 million adults in the US report using it on a weekly basis.

Okay, so we know it’s safe. But, does it work?

To date, reports about valerian effectiveness have been mixed, with some showing benefits with regards to sleep and others, no benefits. In this latest study, researchers evaluated 100 menopausal women between the ages of 50 and 60 who were not using hormones and did not have any medical or psychiatric conditions that would interrupt sleep.  The women, all of whom had been in menopause for at least a year, used a supplement containing 530 mg valerian daily or placebo tablet. Over the course of the study, they were asked to report sleep information using a scientific questionnaire measuring:

  • quality of sleep
  • length of time required to fall asleep
  • length of time asleep
  • ratio of time asleep versus total time in bed
  • anything that disturbed their sleep
  • use of sleeping medication
  • any interruption in daytime activities due to lack of sleep

The result? Valerian was shown to significantly improve sleep quality in as many as 30% of participants compared to placebo, which the researchers say, support its use in the management of insomnia. Moreover, valerian reportedly does so without any significant side effects that are generally associated with sleep agents. Nevertheless, individuals using valerian have reported feeling hungover or drowsy the next day.

Inarguably, many factors affect sleep quality beyond hormones including stress, partner issues, use of alcohol or other drugs or caffeine, light conditions and psychiatric issues like depression and anxiety. In an accompanying editorial, the author claims that in addition to the loss of progesterone, societal pressures are at play, namely the loss of “youthful appearance in a culture drenched with youth-oriented values” and “post-bedtime ruminations” resulting from change in social roles and associated mood disorders. Granted, while cultural issues may be a factor in some women, I hardly believe that  aging’s toll interferes with sleep or that a woman’s sense of worth is an overriding cause of insomnia. Indeed, many optimistic, happy women start losing their sleep numbers as they age.

Regardless of the overriding cause, insomnia affects roughly half of all menopausal women and the problem pervades just about every aspect of a life as a result. If valerian offers relief, I say go for it. If anything, it’s a safe tool that may improve sleep quality.

Got sleep? Maybe valerian holds your key to getting enough zzzs.



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Wednesday Bubble: Soy takes another hit

Posted by on Aug 10, 2011 in bone health, herbal medicine, hot flash | 4 comments

We’re live!

Welcome to the new home of Flashfree! Our URL has changed but the same content that you’ve grown to know and ‘love’ is the same.

Let’s kick off http://flashfree.me with the latest and ‘greatest’ report on soy: it does not help menopausal symptoms or prevent bone loss.

Isn’t this contrary to what’s been reported previously, at least with regards to women with the ability to produce  S-equol?

In this latest nail to the soy coffin, research appearing in the Archives of Internal Medicine suggests that part of the issue in proving or disproving the utility of soy for menopause is the lack of trials of long duration, consistent use of low doses of soy isoflavones, small number of participants and too much breadth and depth of age and menopausal status. However, the SPARE trial (Soy Phytoestrogens as Replacement Estrogen), aimed to change this paradigm by examining the effect of daily 200 mg soy isoflavones in tablet form in 248 women between the age of 45 and 60. All participants had been in menopause for one to five years or for six to 12 months. These women were studied for two years, were instructed to take the active pill or placebo tablet before breakfast, and stop taking any hormones for at least six months before the study started. Calcium was supplemented in women who were taking less than 500 to 1000 mg daily. Importantly, women taking the isoflavone tablets were actually receiving a dose equal to approximately twice that normally obtained through food in Asian diets.

At the study’s end, the researchers found that women taking soy or placebo were on equal footing and that soy did not appear to prevent bone loss or reduce bone turnover. Moreover, soy did not appear to have any significant effect on hot flashes, night sweats, libido or vaginal dryness. They also say that even though women who are able to produce S-equol in their guts were likely to benefit from soy compared to women who are not, they did not see any specific benefit when these women were studied separately. Although not considered a dangerous side effect, constipation was experienced by more than a third of women taking soy.

So, what are we to think? Some studies say soy is effective, particularly among S-equol producers while others, like this well designed trial, show that it is now. However, there has been some data suggesting that the ratio of specific isoflavones may play an important role, and there is no information in the published study about this ratio other than to say that the soy supplement used is similar to those obtained in health food stores.

When it comes to soy, the verdict isn’t quite out yet, although the studies that have been conducted to date can’t seem to tease out what’s what. As always, use caution and lower your expectations. There are other non-hormonal approaches that may provide greater benefit when it comes to bone loss and menopausal hot flashes and other symptoms.

Want to read more on soy isoflavones? Check out the Flashfree archives.

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Wednesday Bubble: Black cohosh – is it safe?

Posted by on Jun 22, 2011 in herbal medicine | 2 comments

Back in 2009, I wrote a post regarding black cohosh (better known in scientific circles as Cimicifuga racemosa) and potential safety issues, namely harm to the liver. In it, I discussed a small case review that showed no link between ingestion of black cohosh and liver toxicity. And yet, in 2006 the European Medicines Agency and the Committee on Herbal Medicinal Products released a public statement alerting health authorities to 42 suspected liver reactions among women taking black cohosh. In the very same report, they noted how inadequately adverse reactions were documented. Indeed, only 16 of the cases were considered to have sufficient data to allow for proper assessment of a potential link, and of these, only four showed any sort of association, albeit, unproven. Regardless,  the statement resulted in Italian health authorities requesting a precautionary withdrawal of black cohosh preparations from the market, and UK authorities issuing strict label requirements and warnings.

Hence, I was intrigued when I ran across a detailed review of black cohosh safety, both from perspective of over 107 patient cases and of published study findings. Following is the lowdown:

  • An Italian clinic regularly prescribed 500 mg or 1000 mg daily black cohosh, either alone or in combination with other herbs (e.g. soy isoflavones, red clover or alfalfa) for treatment of menopause symptoms and disorders (e.g. anxiety, depression, hot flashes and joint pain). None of these herbs were prescribed to women with previous cancer of the breast, ovaries, uterus or pituitary gland. Moreover, the researchers say that they had not received any reports of any sort of adverse event.
  • Still, following the European health statement, they contacted 107 women in good health and in different phases of menopause, took blood samples, underwent clinical examination and participated in phone interviews to evaluate if they were still taking the herbs. Of these women, only five had chronic but benign liver disease and one, hepatitis.

The findings? Despite the four patients suffering from prior benign liver disease, there was no additional sign of liver problems nor altered laboratories indicating a worsening condition or a new condition. Nor were there any clinical signs of liver damage after a year of using high dosages of black cohosh.

The researchers who reviewed and examined patients as well as the published literature point out that the liver is central to metabolizing most drugs and hence, there is a potential for an adverse liver event from taking nearly every medication that involves liver metabolism. They note that a step-by-step examination is also necessary to rule out other causes of liver damage, including infection, alcohol use and related conditions. In so far as herbs go, they write that “it is very important before an official statement about any adverse reaction referred to an herb based product to know the brand, dose of substance assumed, type of extract [and] content of possible contaminants.” They go on to state that it is their opinion the statement could actually be used as proof that black cohosh liver toxicity is scarce because despite over a million doses used worldwide annually, there is not any fully proven case of liver toxicity. Moreover, they claim that black cohosh safety has already been established in over 3,800 participants in clinical trials.  Their conclusion? black cohosh should be considered safe, at least in so far as liver toxicity goes.

What should you do?

If you wish to try black cohosh, speak to a licensed practitioner well versed in herbal medicines. Look for a standardized form to insure that the pills contain what they say they do. And if you start feeling poorly while taking black cohosh? Stop immediately and contact the person responsible for your care.

Black cohosh and liver toxicity. This one appears to be a bubble bursting worthy.

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Wednesday Bubble: Be You Again

Posted by on May 18, 2011 in herbal medicine, Uncategorized | 1 comment

Want to beat the ‘menopause misery?’ Now you can with BeYouAgain.

Not only do I hate the name but I hate the concept that you ever stopped ‘being you’ and instead, became another ‘you’ because of menopause. And while I certainly don’t fault any woman for feeling differently when those damn mood swings, hot flashes, night sweats, headaches, bloating, insomnia or depression hits, I believe that the concept of losing ones soul in the depths of menopause hell is a bunch of hogwash. Trust me; I’ve seen the menopause devil and although she isn’t very pretty, she hasn’t yet robbed me of me.

According to the manufacturer, BetterYou™, BeYouAgain is a “premium sourced food supplement” that contains an “invigorating blend of herbal adaptogens, minerals and vitamins to nourish and revive a tired body.” Not only does it help to “encourage mood maintenance and reduce” axiety, but it also “promotes mental clarity and concentration, alleviates short-term fatigue and helps to maintain a healthy heart and normal blood pressure.” Wow! All these benefits in only two capsules daily.

BeYouAgain contains:

  • maca, to enhance energy, stamina and libido
  • magnesium, to help relax the body
  • milk thistle to protect the liver
  • agnus castus to balance hormones
  • Siberian ginseng to maintain energy
  • Cayenne pepper to enhance circulation and digestion

And, a host of other vitamins and minerals to boost these processes.

Stop. Really. Stop and think.

Two pills, one size fits all, menopause hype.

You’re not you but you can be you if you simply take “BeYouAgain” daily.

I don’t know what part of this story is more insulting. The fact that the manufacturers want you to believe that you’ve lost a part of you that can be regained with supplements. Or the story that menopause steals your soul in the first place.

The She Devil? I’d take a guess that she’s residing in Better You.

Bursting this one.

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Soy. Is it safe?

Posted by on Jan 3, 2011 in diet, herbal medicine, osteoporosis | 0 comments

For years, researchers have been exploring the potential of soy isoflavones — naturally-occurring plant estrogens — for alleviating menopausal symptoms such as hot flashes, atrophy and bone loss. Thus far, certain components of soy, including genestein and S-equol have shown the most promise. However, are they safe?  And, as the adoption of soy as a viable alternative to risk-ridden hormone replacement therapy continues to grow, and women turn to supplements rather than food-based soy, is there anything that they need to worry about in terms of side effects?

Researchers recently evaluated this question in a study of 403 postmenopausal women who took  either 80 mg soy tablets, 120 mg soy tablets or placebo tablet daily for  two years. The particular type of soy isoflavones used were hypocotyl isoflavones, which are a byproduct of soy protein and (very rich in daidzein – the second most plentiful isoflavone in soy. The effects of the supplements were measured at the study’s start, at one year and at the end via blood tests and a well-woman examination (i.e. mammogram, pap smear, x-rays to measure bone density). A smaller group of women also had ultrasounds done to determine any possible effects on the lining of the uterus or development of fibroids.

Although the primary goal of the study was to determine the effects of this type of soy supplement on osteoporosis and bone loss, the researchers discovered that taking soy supplements during this time period did not present any major risk to health and did not affect thyroid function. Although one participant developed breast cancer during the study and one, endometrial cancer, 1) utrasounds in the subgroup of women who received them did not show any uterine thickening and 2) the rate of cancer development in this study, only two women over a two year time period, was considerably lower than statistically likely in a general population of women. Both of these factors support the contention that soy isoflavones are not likely to promote either cancers.

So, is soy safe over the long-term? It appears that it is. HOWEVER, bear in mind that the type of soy used in this study is are very different that the type that is commonly sold over the counter, which commonly contain higher percentages of genistein, the most plentiful isoflavone component in soy.

And what about osteoporosis? This particular paper did not address those specific results, although others have. Thus far, the results have been mixed. However, this particular study, better known as OPUS (Osteoporosis Prevention Using Soy)is one of the largest and most comprehensive to date and those findings are likely to come to light soon.

In the interim, if you are going to be taking soy in supplement form, be mindful that your exposure is likely to be as one to four times that a typical Asian diet and as much as 100 times that of a typical Western diet. While these level do not appear to be harmful, herbal and plant medicines are not without risk so as always, the rule of thumb is be vigilant and speak to a health practitioner first.

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Menopausal symptoms? Treat them with Ease…

Posted by on Aug 20, 2010 in herbal medicine | 3 comments

Or not.

I just wind of a new product called EaseFemin™, a supplement with a proprietery formulation that the manufacturers are calling IsoFactor™. These specific isoflavones and flavare derived from a unique Brazilian red propolis, which is a resin collected by honeybees. Evidently, propolis has been used in folk medicine since around 300 BC and clinical data show that it is non-toxic.

Theoretically, Ease-Femin™ taken once-daily, addresses irritability, hot flashes and night sweats. Moreover, an antioxidant has been added to fight cellular damage caused by free radicals circulating in the bloodstream.

Does this sound a bit too good to be true?

I would say, yes.

My first concern is that I did a search on propolis. And as an isoflavone compound, it’s not been studied extensively in menopause or any other condition. The second concern I have lies with isoflavones themselves. As I’ve written of late, it seems that only specific isoflavone compounds, namely S-Equol and daidzein, appear to have any sort of demonstrable effect on hormonal symptoms. So I am not entirely convinced about whether or not this is an exciting new avenue or the promise of spending money ($36.99 a month) for a product that won’t do much of anything.

This is another case of buyer beware. The research simply isn’t there to back the use of the product. At least not yet.

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