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apollog

Herbal Syneries

apollog
15 years ago

I thought that the objections to the idea of herbal synergy posted in a few other threads would make for an interesting thread on its own. Here is an abstract I came across in a journal that suggests that synergism is real:

Synergy and other interactions in phytomedicines

E.M. Williamson

The School of Pharmacy, University of London, London, United Kingdom

"Synergistic interactions are of vital importance in phytomedicines, to explain difficulties in always isolating a single active ingredient, and explain the efficacy of apparently low doses of active constituents in a herbal product. This concept, that a whole or partially purified extract of a plant offers advantages over a single isolated ingredient, also underpins the philosophy of herbal medicine. Evidence to support the occurrence of synergy in phytomedicines is now accumulating and is reviewed here. Synergistic interactions are documented for constituents within a total extract of a single herb, as well as between different herbs in a formulation. Positive and negative aspects of interactions are discussed together with the methods used to identify and measure synergy. The evidence is divided into experimental, in vitro instances, as well as clinical examples where available. Herbs discussed include Ginkgo biloba, Piper methysticum (Kava-Kava), Glycyrrhiza glabra, Hypericum perforatum, Valeriana officinalis, Cannabis sativa, Salix albaand others." (in Phytomedicine,

Volume 8, Issue 5, 2001, Pages 401-409.)

Comments (27)

  • apollog
    Original Author
    15 years ago
    last modified: 9 years ago

    Oops. Synergies. Not syneries.

  • lucy
    15 years ago
    last modified: 9 years ago

    You know, I don't normally go around correcting other people's typos, but I did it (in the other note) because it had been used 2-3 times, so it was unlikely to be a typo per se, and because there was a little history leading up to it (in the form of my being accused of all kinds of nefarious things), so I was feeling a little witchy... that's all.

  • apollog
    Original Author
    15 years ago
    last modified: 9 years ago

    Water under the bridge, something to let pass ... I should have done more QA/QC on this one, but I was multitasking. :)

  • rusty_blackhaw
    15 years ago
    last modified: 9 years ago

    It wouldn't surprise me if, as the author apollog is citing claims, there are "positive and negative aspects of interactions" between components of herbs (although no specific examples that relate to everyday use of herbs are mentioned).

    No one here has "object(ed) to the idea of herbal synergy". What some are skeptical about is the near-mystical belief that whole herbs were designed to contain everything people need, and that we should assume that purifying and standardizing their components is wrong.

    This belief is very convenient for herb and supplement dealers, because they don't have to ensure that effective doses and purified ingredients are present in what they sell. Tossing some dried herb or a crude extract into a bottle saves them money.

    It's not so great for consumers, who often wind up with variable quality and sometimes little or none of the active principle contained in the product.

  • tasymo
    15 years ago
    last modified: 9 years ago

    O.K., I'm hesitant to suggest examining this Herb, simply because I am so fond of it and it's history and I'd hate to see it "torn to pieces", but here it is anyway.

    Motherwort (leonurus cardiaca)

    According to one of my books:

    Constituents- Alkaloids (including leonurinine and stachydrine), bitter glycosides (leonurine and leonuridin), tannins, a volatile oil, vitamin A.

    Main medical uses- to regulate menstruation

    The English name indicates an important use of this herb as a sedative particularly valuable in treating the anxiety after childbirth or at the menopause. This effect is thought to be due to the glycosides which also seem to have a short-term ability to lower blood pressure.
    The Latin name, cardiaca, derives from the Greek word for heart. Since ancient times, Motherwort has been used to treat palpitations and rapid heartbeat, especially when associated with anxiety. Chinese herbalists also use Motherwort for it's diuretic properties. Motherwort is invaluable for treating absent or painful periods particularly when the flow is scanty. It can help regulate menstruation and treat functional infertility.

    CAUTION- The alkaloid stachydrine has the effect of hastening childbirth, so the herb should not be taken during pregnancy. Chinese research on Leonurus heterophyllus, a relative of the European Motherwort, showed that decoctions of the plant were as effective as the drug ergotamine in causing the uterus to contract after delivery.

    Seems to me there is a definite SYNERGY at work within this herb. Comments?

  • rusty_blackhaw
    15 years ago
    last modified: 9 years ago

    I grow this plant in my garden (picked it up on sale unlabeled and later identified it - thanks for adding a little more information to my knowledge of how it's been used).

    I haven't seen information that any of this herb's components are syngergistic (meaning that two or more components act together to produce a greater effect than either singly). When taken during labor (still used this way by some midwives), it's said to have both a stimulant and relaxant effect on the uterus, so that'd be the opposite of synergism.

  • brendan_of_bonsai
    15 years ago
    last modified: 9 years ago

    While that abstract may be true, I think that the shear volume of bad information out in the world about herbs so eclipses the amount of good information that bringing up synergy in defense of herbs is like bringing up the WMD's used to attack Kuwait in defense of the American Invasion of Iraq.

  • tasymo
    15 years ago
    last modified: 9 years ago

    "Synergy (from the Greek syn-ergo, µÃ­Ã¥Ã±Ã£Ã¼Ã² meaning working together) refers to the phenomenon in which two or more discrete influences or agents acting together create an effect greater than that predicted by knowing only the separate effects of the individual agents. It is originally a scientific term.

    Synergy can also mean:

    *A mutually advantageous conjunction where the whole is greater than the sum of the parts.
    *A dynamic state in which combined action is favored over the sum of individual component actions.
    *Behavior of whole systems unpredicted by the behavior of their parts taken separately. More accurately known as emergent behavior"

    The different components in Motherwort appear to both relax and stimulate the patient in a beneficial manner, simaltaniously and without interfering with each other. In other words, working TOGETHER to ease the symptoms. Is synergy only to be applied to single symtoms?

  • rusty_blackhaw
    15 years ago
    last modified: 9 years ago

    "The different components in Motherwort appear to both relax and stimulate the patient in a beneficial manner, simaltaniously and without interfering with each other. In other words, working TOGETHER to ease the symptoms."

    This is the point at which I'd say "Show me the money".

    In other words, where's the evidence that opposite actions take place that benefit the patient (aside from folklore and testimonials)?

  • tasymo
    15 years ago
    last modified: 9 years ago

    Where is your evidence that it doesn't work?

  • brendan_of_bonsai
    15 years ago
    last modified: 9 years ago

    You see the burden of proof is on you if you want to charge money for it and or claim that it does anything that someone else may be offering. If everyone proved what they claim to be true it wouldn't take long, if we had to go through and prove everyones claims false for them it would cost us trillions of dollars per patient and take several thousand man years per patient. Big pharma has to prove that their product does better than placebo with a placebo controlled double blind study and so should the herb people. The plural of anecdote is anecdotes, not evidence.

  • apollog
    Original Author
    15 years ago
    last modified: 9 years ago

    >> You see the burden of proof is on you if you want to charge money for it and or claim that it does anything that someone else may be offering.

    The burden of proof is on anyone who makes affirmative claims. B_of_B claimed that synergy can't be effectively studied and is merely magical thinking. Such a broad sweeping claim was proven wrong in the article cited above.

  • rusty_blackhaw
    15 years ago
    last modified: 9 years ago

    " B_of_B claimed that synergy can't be effectively studied and is merely magical thinking."

    Has anyone made such a statement in this forum?

    "The burden of proof is on anyone who makes affirmative claims."

    True. A claim such as "Whole herbs are superior to purified extracts because of synergistic effects" carries with it a burden of proof (for example, well-designed clinical trials demonstrating that in most cases, superior results are obtained with whole herb preparations because of synergy. To my knowledge, such evidence does not exist).

  • tasymo
    15 years ago
    last modified: 9 years ago

    Yes, Eric, Brendan stated- in the thread pertaining Herbs useful to middle-stage congestive heart failure. I believe it was this statement that spurred Apollog to begin this thread.

    I find it difficult to believe that the medical/scientific community isn't advanced enough study synergy. Also, what's up with this "magical thinking" nonsense? Brendan, do you honestly believe that Herbalists think that Herbs are magical?? We've come a long way since Herbs were first used for medicinal purposes, and have a far better understanding of why they work. That is what the study of Herbalism is all about. I think the debate is whether isolating active constituents from thier synergistic fellows in an improvement, or not.

  • rusty_blackhaw
    15 years ago
    last modified: 9 years ago

    I see - brendan actually said that our ability to study syngergistic effects of meds is limited (not that it "can't be effectively studied").

    It can in fact be researched, and the principle is known and utilized in pharmacology.

    I agree with what seems to be his main point - that it's unfortunate that some proponents of herbalism think that the complex stew of compounds/chemicals present in medicinal herbs should be assumed to work together for the benefit of mankind, and that "tampering" with the whole herb to produce a purified extract with known amounts of the active substance(s) is suspect.

    That's what has overtones of magical thinking - and in fact I recall a previous discussion in this forum in which a poster flat-out declared that herbs were put on earth by God to benefit man.

    People who have religious beliefs on the subject are not going to accept the idea that organisms other than man evolved for their own benefit and protection. A less human-centered and non-magical approach is to consider that herbs and other organisms have properties that can help us, harm us, or have no significant effect either way - and that the best approach is to carefully select for those properties that are beneficial, and aim to produce them in a consistent, reproducible fashion.

    To cite a non-herbal example, raw snake venom is harmful and even fatal when injected into the bloodstream. However, derivates of snake venom have potential applications in controlling clotting during surgery and helping stroke patients recover.

  • brendan_of_bonsai
    15 years ago
    last modified: 9 years ago

    Apollog and tasymo My intent was not to imply that synergy could not be studied, just that we are not advanced enough to study the full breadth of it. Science based medicine is only a few hundred years old, already we have made more advances than magic based medicine made in its 100,000 years of practice. Science does that by not assuming, by being skeptical of every apparent effect. It takes a huge number of people to determine which combination of compounds A,B,C,D,E,F, and G are best for one condition or another, then when we look at something like saint johns wort with its hundreds of possible active compounds in order to find the best combination we would literally need a group of about 2 billion people with moderate depression and high functioning livers. Eventually we will be able to look at an herb in the field and be able to tell what levels of what chemicals are in what parts, now we just assume, and assuming that things will work out for the best just because you do something is the basis of magic based medicine, which gets us no where.

  • apollog
    Original Author
    15 years ago
    last modified: 9 years ago

    Sure, science is based on skepticism and proof. But you are bringing some biases and assumptions to the table. If an herb works and it tests 'safe' within reason, does it matter if there is one ingredient or 10 in it? The simple fact is that it works! Do we really 2 billion people to test every combination of ingredients in SJW? I think that notion is ridiculous. Pharma surely doesn't test all the thousands of possible permutations of a molecule they are looking at for a disease- they narrow things down, pick one, and go with that. Sometimes it pans out, sometimes it doesn't, that's simply one approach to doing things. No proof that it is inherently better or worse, apart from the undeniable economic fact that defined novel compounds are patentable and are rewarded with a legal monopoly.

    Having a medicine that is entirely chemically defined is not all bad, but it is over-rated. When medicine can standardize the patient and patient response to something, then they will have something to crow about. The standard answer is genomics and medicines tailored to the patient.... great in theory, but that becomes far more complicated and expensive than anything you have suggested - we are talking about identifying millions and millions of genes and varieties of genes (and all the possible interactions), and then testing some one for all of those ... good luck.

    Many people think there is some clearly defined line between food and medicine, but I don't see evidence for that. While opium is clearly a drug, and pure water is clearly not, there are lots of foods/herbs and their chemicals that fall in the gray area in between. And just as most people would say that the best diet is diversified (and not narrow, chemically defined fare), I would argue that the best treatment for many diseases or conditions is often not a single defined chemical, but a diversified group of phytochemicals which often (but not always) can be shown to work in synergy.

  • brendan_of_bonsai
    15 years ago
    last modified: 9 years ago

    Well if an herb tests less safe, less reliable, and less efficacious than a single compound does any reason exist to use the herb? Most herbs in use have not been conclusively shown to work, bottom line, the studies have not been done. And when the studies have been done most of the pills you buy have not been shown to contain any grade of herb so if the study has shown the herb to work that doesn't mean anything about the product the consumer gets. That is the drawback to taking things as herbs, and that is why we study synergy and try to replicate it and to purify out the good actors and get rid of the bad ones. In some cases herbs still are the best answer, but those are few and far between when you consider the dangerous drawbacks to the wild form of medicine. Also keep in mind that big pharma can get a legal monopoly on a compound derived from an herb, or a group of compounds, the only reason that big pharma isn't testing echinacea or SJW or burdock is that the evidence doesn't point to much useful coming from them compared to drugs already on the market. You may be interested to know that someone just patented bakingsoda again for use in MRI's, BAKING SODA! You are saying go with synergy for effect, I'm saying test first for safety.

    I'm saying that we should identify first then act, you are saying that its alright to guess. Thats what you are doing with herbs, you are guessing at the dose you are getting, you are guessing that no extra chemicals in the herb are going to interfere with anything you want to happen and you are guessing that synergy is occurring. All of this with little or no basis.

    A diverse diet is good because it helps us get all of the things we need a little of and avoid getting too much of the things we don't need to much of, with medicine we are typically going after one thing that has gone wrong pathologically, trying to activate one receptor, and typically a whole bunch of chemicals grabbed essentially at random (well, they are in the same plant, but from a human physiology standpoint they have nothing in common) aren't going to accoplish that one task with out interference, sure many times a group of chemicals will have better effect than just the one, but there is no reason to think that the group of chemicals we find in any given herb is better than just one chemical from any standpoint until the tests have been run.

  • apollog
    Original Author
    15 years ago
    last modified: 9 years ago

    >> In some cases herbs still are the best answer, but those are few and far between when you consider the dangerous drawbacks to the wild form of medicine.

    That's a rather sweeping statement - what are the dangerous drawbacks to the "wild" form of medicine?

    >> Also keep in mind that big pharma can get a legal monopoly on a compound derived from an herb, or a group of compounds, the only reason that big pharma isn't testing echinacea or SJW or burdock is that the evidence doesn't point to much useful coming from them compared to drugs already on the market.

    Sure, someone could patent a compound or the use of a compound - if it is novel. But if an herb (like SJW) has long been used for treating depression, and if the chemical or synergistic group of chemicals that are in SJW were discovered long ago, there is very little newness to warrant a patent.

    Numerous studies have shown that SJW is comparable to existing antidepressants in efficacy, and generally has a lower side effects profile. I don't think that the pharmaceutical companies are being evil, but the rules are set up so that their first goal is making money. If they could develop a product that was equal to (or even somewhat inferior) to existing products but much more profitable, they absolutely should push that product. Because the function of the corporation is to return as much profit to the owners as possible. The fact that they may need to meet some 'need,' or that the 'solution' is also much more expensive to the consumer is incidental and irrelevant to the driving force of the corporation.

    Drugs are no different than shampoo - sure, a decent product could be produced at a very low cost. But instead, we see thousands of products competing against each other to fill the same basic function of removing dirt and oils from the hair. There are shampoos pitched specifically to males or females, specifically to particular age groups, different economic groups, different ethnic groups, etc. In the marketplace, demographics and psychological needs are more important than physical needs.

    >> with medicine we are typically going after one thing that has gone wrong pathologically, trying to activate one receptor, and typically a whole bunch of chemicals grabbed essentially at random (well, they are in the same plant, but from a human physiology standpoint they have nothing in common)

    In a few cases, that is true, but more often, it is not. If a child has a fever, is holding its ear and screaming in pain, an antibiotic is a good choice to relieve an acute infection. But if the child comes back time after time with ear infections, then maybe the real problem is not antibiotic related - it could be air or water quality, a nutritional deficiency, the bacterial ecology of their sinuses, sanitation, or a variety of other things. The focus on 'the one thing that has gone wrong pathologically' (bacteria) can easily become myopia.

    Illness generally involves more than one thing that has gone wrong - activating or blocking one gene or receptor may help, but complex systems are rarely optimized with a single such tweak. The 'modern' approach to heart disease has focused very narrowly on cholesterol and the HMG-CoA receptors, and that has yielded some progress. But cholesterol is only one part of the atherogenic process, accounting for 30-40% of risk. Half of men who have their first heart attack have normal cholesterol levels. What about CRP, homocysteine, inflammatory cytokines, reactive oxidation, platelet aggregation, and a host of other factors? What about the complex patterns of gene expression that exist in various diseases, or in health?

  • rusty_blackhaw
    15 years ago
    last modified: 9 years ago

    "what are the dangerous drawbacks to the "wild" form of medicine?"

    I believe he's thinking about the hazards of using digitalis from the garden to make your own heart drug (and hoping that underdosage or toxic overdosage don't cause trouble), making a tincture of Pacific yew to treat cancer instead of Taxol, and so on.

    "Numerous studies have shown that SJW is comparable to existing antidepressants in efficacy, and generally has a lower side effects profile."

    If this was true physicians would have been switching to it in droves, and drug companies would have gotten purified and reworked formulations on the market to enhance their "bottom line". The truth is that SJW, while showing some effectiveness in treating mild depression, has fallen flat more recently in better-conducted trials that examined its potential role in more serious depression (of course, not all prescription antidepressants far all that well in this setting also).

    "But if the child comes back time after time with ear infections, then maybe the real problem is not antibiotic related - it could be air or water quality, a nutritional deficiency..."

    Chasing after those "causes" is going to do little good. If a child is so severely malnourished that he/she's more susceptible to infection, it's not likely to be overlooked by the physician. Genetic and physical causes of repeated infection do in fact come into play if warranted. Prevention is also an issue (i.e. greater exposure to pathogens in day care settings).

    Another straw man argument is that multiple lines of research into heart disease are not being explored - of course, they are.
    The "herbal polyphenols" sound interesting, although if they're actually capable of altering the action of DNA, the potentially for toxicity is worrisome. Maybe when this research gets out of the test tube stage, such questions can be answered.

  • rusty_blackhaw
    15 years ago
    last modified: 9 years ago

    One type of "air quality" that actually does have an effect on chronic ear infections in kids involves secondhand smoke. Making this connection plain to smoking parents can lead to fewer infections if they're willing to take responsibility for not smoking in the home.

    This is more of a "parenting synergy" than an "herbal synergy". :)

  • apollog
    Original Author
    15 years ago
    last modified: 9 years ago

    >> The "herbal polyphenols" sound interesting, although if they're actually capable of altering the action of DNA, the potentially for toxicity is worrisome.

    Que? The fact that something can change the action of a large number of genes is not unusual or an indication of toxicity. If the average person gets more vitamin D, it will change the action of approximately 1000 genes. Of course, an extreme amount of vitamin D can be toxic, but many genes get switched on/off due to fluctuations in vitamin D intake well below the toxic level.

  • brendan_of_bonsai
    15 years ago
    last modified: 9 years ago

    Actually the ability to change the action of DNA is an extremely useful indicator of potential toxicity, If you change the output of large numbers of genes you kill an organism often times. However I suspect Eric has something else to base his idea on, like maybe a toxicity study.

  • apollog
    Original Author
    15 years ago
    last modified: 9 years ago

    >> Chasing after those "causes" is going to do little good. If a child is so severely malnourished that he/she's more susceptible to infection, it's not likely to be overlooked by the physician.

    There's absolutely no evidence that a child must be 'severely malnourished' in a way that any physician would recognize to be at an increased risk of various infections or other diseases. Research has shown that children with recurrent ear infections tend to have low levels of omega-3 fatty acids, vitamin A and selenium, and that correcting these deficiencies reduces the number of infections.

    The rate of ear infections and recurrent ear infections has gone up for the past several decades. It's a shame that so many doctors assume that it is a waste of time to chase after the root causes that are making the disease more common - No need to prevent, just slap it down with antibiotics when it (increasingly) occurs?? Because medicine isn't concerned with health and all its complexities, the role of medicine is to correct specific pathologies, which must first be allowed to develop??

    >> One type of "air quality" that actually does have an effect on chronic ear infections in kids involves secondhand smoke. Making this connection plain to smoking parents can lead to fewer infections if they're willing to take responsibility for not smoking in the home.

    Sure, second hand smoke is a real factor, as are dust mites, mold spores, particulate pollution from industry, and many other factors that affect not just air quality, but the health of the people breathing that air. And the research shows that recurrent ear infections are most common in children in affluent families (which are less likely to have parents who smoke in the house) ... although the impoverished families are catching up. Blaming the parents doesn't solve the problem.

  • apollog
    Original Author
    15 years ago
    last modified: 9 years ago

    >> Actually the ability to change the action of DNA is an extremely useful indicator of potential toxicity, If you change the output of large numbers of genes you kill an organism often times.

    What do you mean by 'change the action of DNA'?? Exercise has profound effects on the expression of genes - one study found "In total, 113 genes increased 3 h postexercise, and 34 decreased." That was only in the leg muscle - no telling what other changes occur in the heart, the vacular system, the brain, the lungs, etc. Should we refrain from exercising, then, because it changes DNA action and might kill our organism??

    >> However I suspect Eric has something else to base his idea on, like maybe a toxicity study.

    Hmmm ... faith-based validation of claims?

    Really, this is an issue of complexity. In complex systems, non-linear interaction of variables is the norm.

    Here's a paper that looked at the effects of different anaesthetics. They found that similar type anaesthetic drugs tended to have a linear interaction, but that mixing different categories of compounds more often than not resulted in synergies. In a plant-based mixture, there are usually a variety of different classes compounds (polyphenols, alkaloids, peptides, etc ) ... likely to often result in synergies.

  • brendan_of_bonsai
    15 years ago
    last modified: 9 years ago

    Too much exercise can kill you!

    But seriously anything that has pharmacological activity has the potential to change things in a bad way, any chemicals that change things in a bad way and kill you are toxic, so these chemicals have a good chance of being toxic.

    Aaaaaand I stated my suspicion, you cannot turn that into an affirmative claim no matter how you try.

  • rusty_blackhaw
    15 years ago
    last modified: 9 years ago

    "Que"? How...continental. :)

    I think people are capable of distinguishing between what exercise might and might not do as far as gene expression, as opposed to the action of untried and untested drugs (such as herbal polyphenols). Exercise is natural - drugs are not.

    The business about physicians not being interested in causes of chronic ear infections and just wanting to push antibiotics is a strawman argument. As noted, physicians do consider potential environmental, physical and genetic causes for chronic infections. Worrying about industrial air pollutants and "water quality" is not going to be of much tangible help to parents.

    As for selenium and such, it'd be interesting to see what evidence apollog thinks makes such alleged deficiencies a curable factor. I don't see any corroborative information in those last two links, though (one merely talks about increases in ear infections and the other relates to synergies in non-herbal drugs).

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