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3/29/2017
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Functional Phytotherapy for Clinical SuccessKerry BoneAdjunct Professor New York Chiropractic College
Disclaimer
Integria Healthcare and Standard Process®sponsor these webinars to provide health care information to practitioners and to provide them the opportunity to hear about the views, recommendations and experiences of other practitioners. Health related information provided here is not a substitute of medical advice.Integria, Standard Process and the speaker, Kerry Bone, have not evaluated the legal status of any products (except for Standard Process and MediHerb products), services or recommendations with respect to state or federal laws, including scope of practice. Integria, Standard Process and Kerry Bone do not and cannot accept responsibility for errors or omissions or for any consequences from applications of the information provided and makes no warranty, expressed or implied, with respect to the information provided.
Recommendations for Standard Process and MediHerb product dosages are those of the speaker and sometimes different than the doses that appear on the product labels. Please refer to the product labels or to the product descriptions found in the product catalogs or on the website for Standard Process and MediHerb dosage recommendations.
*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.
Professor Kerry BoneKerry Bone is the co-founder and innovation driver at MediHerb, where he serves as Director of Research and Development. In 2016 MediHerb was awarded the American Botanical Council’s (ABC’s) Varro E. Tyler Award for excellence in Phytomedicinal Research. As part of his educational role, Kerry is Principal of the Australian College of Phytotherapy and also Adjunct Professor at New York Chiropractic College, providing input into their postgraduate applied nutrition program. Kerry is co-author of more than 30 scientific papers on herbal research. He has also written and co-written six popular textbooks on herbal medicine, including his latest, the second edition of Principles and Practice of Phytotherapy which was awarded the 2013 James A. Duke Excellence in Botanical Literature Award by the ABC. Kerry maintains a busy herbal and naturopathic practice in Toowoomba, Queensland, where he has been in continuous service for more than 30 years. In 2015, Kerry’s lifelong contribution to the field of herbal medicine was recognized with his receiving the prestigious Lady Cilento award from the complementary medicine industry in Australia.
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Our Topics
• Success with symptom-based prescribing
• Functional phytotherapy roots
• What is functional medicine?
• Defining functional phytotherapy: key attributes
• Twelve core strategies of functional phytotherapy
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Success with symptom-based prescribing
Mauro Raffaelli/ CC-BY-SA-3.0 / https://commons.wikimedia.org/wiki/File:584-fiori_di_incenso.JPG
15 Reliable Herbs that Deliver Results!
• Boswellia
• Licorice
• Tribulus
• Andrographis
• Echinacea Root
• Kava
• Rhodiola
• Ashwagandha6
• Horsechestnut
• St John’s Wort
• Eyebright
• Gymnema
• Gotu Kola
• Ginkgo
• Korean Ginseng
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15 Reliable Herbs that Deliver Results!
Boswellia joint health post-exercise musculoskeletal
inflammation in general gastrointestinal health best in combination
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013
15 Reliable Herbs that Deliver Results!
Licorice HPA axis support;
adrenal restoration reduces sweet cravings addresses indigestion
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013
Image: Raffi Kojian/http://Gardenology.org/ CC-BY-SA-3.0 / https://commons.wikimedia.org/wiki/File:Gardenology.org-IMG_2804_rbgs11jan.jpg
15 Reliable Herbs that Deliver Results!
Tribulus Leaf supports normal reproductive
function in men and women also a male tonic: libido and
performance menopausal symptoms
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: Raffi Kojian/http://Gardenology.org/ CC-BY-SA-3.0 / https://commons.wikimedia.org/wiki/File:Starr_030612-0063_Tribulus_terrestris.jpg
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15 Reliable Herbs that Deliver Results!
Andrographis short-term immune system
support upper respiratory support non-cystic acne
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013
Image: J.M.Garg / Creative Commons Attribution-Share Alike 4.0 International https://commons.wikimedia.org/wiki/File:Andrographis_paniculata_(Kalpa)_in_Narshapur_forest,_AP_W_IMG_0871.jpg
15 Reliable Herbs that Deliver Results!
Echinacea Root immune system support useful as well for treatment,
but with Andrographis does not deplete the immune
system with continuous use
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013
15 Reliable Herbs that Deliver Results!
Kava amazingly good for anxiety
and difficulty sleeping relaxes muscle, both smooth
and skeletal depressed mood if comorbid
with anxiety
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: Poyt448, Peter Woodard / Creative Commons Attribution-Share Alike 4.0 International / https://commons.wikimedia.org/wiki/File:Big_leaf_plant_Lord_Howe_Island_lowland.jpg
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15 Reliable Herbs that Deliver Results!
Rhodiola fatigue, physical stress,
convalescence depressed mood improves performance
(mental and physical)
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: Σ64 / CC-BY-SA-3.0 /https://commons.wikimedia.org/wiki/File:Rhodiola_rosea_01.jpg
15 Reliable Herbs that Deliver Results!
Ashwagandha as for Rhodiola previously
but for anxiety, rather than depressed mood, and is a more calming tonic
boosts DHEA, testosterone and thyroxin
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine2nd edition, Elsevier, UK, 2013
Image: Hari Prasad Nadig, Vinayaraj / CC-BY-SA-2.0 / https://commons.wikimedia.org/wiki/File:Ashwagandha.jpg
15 Reliable Herbs that Deliver Results!
Horsechestnut varicose vein symptoms
and hemorrhoids unexplained balance issues soft tissue compression
syndromes
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: http://s0.geograph.org.uk/geophotos/03/00/09/3000989_a92d2f53.jpg
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15 Reliable Herbs that Deliver Results!
St John’s Wort gold standard evidence
for low mood can be effective for
exercise-related nerve pain immune support
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: Bob Peterson/ CC-BY-SA-2.0 / https://commons.wikimedia.org/wiki/File:Peelbark_St._Johns-wort_(Hypericum_fasciculatum)_(6439017119).jpg
15 Reliable Herbs that Deliver Results!
Eyebright for upper respiratory system relief good also for dry, irritated eyes best combined with Golden Seal
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: Enrico Blasutto/ Creative Commons Attribution-Share Alike 3.0 Unported / https://commons.wikimedia.org/wiki/File:Euphrasia_rostkoviana_ENBLA02.jpeg
15 Reliable Herbs that Deliver Results!
Gymnema supports the endocrine
pancreas long- and short-term effects
on blood sugar metabolism reduces sweet cravings
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: Slick-o-bot / CC-BY-SA-2.0 / https://commons.wikimedia.org/wiki/File:Gymnema_sylvestre_R.Br_-_Flickr_-_lalithamba.jpg
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15 Reliable Herbs that Deliver Results!
Gotu Kola supports natural healing
by promoting connective tissue also benefits the microcirculation is a proven brain tonic varicose vein symptoms and
hemorrhoids
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: Forest & Kim Starr / CC-BY-SA-3.0 Unported / https://commons.wikimedia.org/wiki/File:Starr_020803-0094_Centella_asiatica.jpg
15 Reliable Herbs that Deliver Results!
Ginkgo good for focus and short-term
memory age-related cognitive decline also benefits the microcirculation
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013
Image: http://maxpixel.freegreatpicture.com/Ginkgo-Biloba-Fruit-Gingko-Tree-Fukushima-Tree-610016
15 Reliable Herbs that Deliver Results!
Korean Ginseng fatigue, physical stress,
convalescence improves performance
(mental and physical) also a male tonic: libido
and performance long-term immune system support supports the heart
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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: FloralFarm GmbH/Katharina Lohrie/ CC-BY-SA-3.0 Unported / https://commons.wikimedia.org/wiki/File:Ginsengpflanze.jpg
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Functional Phytotherapy
James Diedrick ?https://www.flickr.com/photos/jkdatlanta/3497413025
Roots: Thomsonian Medicine
1. Health follows from obeying natural laws
2. Disease is an obstruction or diminution of vital energy
3. It is caused by violation of natural laws
4. Symptoms, such as fever, are due to the effect of the disease and are not the disease itself
5. Disease has only one basic type of cure – to remove obstructions or restore vital energy using substances that act in harmony with natural laws and the vital energy
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Thomsonian Medicine
6. In doing so one or more of the following effects should be accomplished:
a) Relaxation
b) Contraction
c) Stimulation
d) Soothing
e) Nourishing
f) Neutralization
24Image: Lloyd, John Uri; Waterhouse, Benjamin. 1909. "Life and medical discoveries of Samuel Thomson, and a history of the Thomsonian materia medica, as shown in 'The new guide to health,' (1835) and the literature of that day". Cincinnati, O., J.U. & C.G. Lloyd/https://commons.wikimedia.org/wiki/File:Samuel_Thomson.jpg / PD-US
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Physiomedicalism
• Physiomedicalists were neo-Thomsonians
• Thurston (1900) was greatly influenced by the research findings on the autonomic nervous system
• He extended basic concepts into an elaborate therapeutic system (somewhat inaccessible to the modern reader)
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Functional Medicine
• Addresses the underlying causes of disease
• Uses a systems-oriented approach
• Is patient-centered rather than disease-centered (the whole person, not just an isolated set of symptoms)
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www. functionalmedicine.orgImage: https://c1.staticflickr.com/7/6207/6052491503_c719b2a6b3_b.jpg
Functional Medicine
• History together with genetic, environmental and lifestyle factors are paramount: the matrix
• Supports the unique expression of health and vitality for each individual
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Functional Phytotherapy
1. Understanding diseases as disordered processes of normal physiology
2. Mosaic diseases: the individual story counts most
3. Complex interventions for complex multifactorial disorders (network pharmacology)
4. Therapy based on 12 core strategic targets
5. But the key over-riding consideration is to support the tissue
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Mosaic Disease
• Concept first proposed by Irvine Page in 1950 in the context of hypertension1
• Later in 1989 Yehuda Shoenfeld coined the term for autoimmune disease (AiD)2
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1.Page IH. Hypertension 1982; 4(2): 1772.Shoenfeld Y, Isenberg DA. Immunol Today 1989; 10(4): 123-126
Mosaic Disease Principles
• A syndrome or disease differs in expression shares many common factors (pieces or tiles)
• Each piece is a causative factor in the disease
• Each patient is a unique picture
• Due to the random (stochastic) combination of causative factors
• THE PATIENT’S STORY IS PARAMOUNT
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The Three P’s of Causation
Predisposing – e.g. genetics
Precipitating – e.g. pathogens
Perpetuating – e.g. maladaptive stress response
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Applying the OST Rule
Overlap therapeutic activity use complex treatments
Sequence treatments not everything at once
Triage set priorities
32Image: UVM Scribe/ CC-BY-SA-3.0 / https://en.wikipedia.org/wiki/File:UW_surgery_and_residents.jpg
Complex Interventions for Complex Disorders
• Multiple factors require multiple interventions
• Determined for each patient by their case history
• Targeting just one point in a pathophysiological network and completely shutting it down risks side effects and does not resolve the disease
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Herbs as Inherently Complex Interventions
• Gertsch observed that herbal extracts might be complex but are in fact “intelligent mixtures” of secondary plant metabolites shaped by evolutionary pressures
• He notes the concept of network pharmacology, as originally proposed by Hopkins
34Gertsch J. Planta Med 2011; 77(11): 1086-1098
Functional Phytotherapy
The 12 core strategies1. Support key endocrine responses:
• HPA axis• thyroid• pancreatic beta cells• enteroendocrine cells• male/female as appropriate
35Image: BrianMSweis/ CC-BY-SA-3.0 Unported / https://commons.wikimedia.org/wiki/File:Brian_M_Sweis_HPA_Axis_Diagram_2012.pdf
Functional Phytotherapy
2. Eliminate naturally occurring pathogens
3. Protect and re-energize cells • boost cellular protection (cytoprotection)• lower danger signals• enhance mitochondrial function and biogenesis
4. Detoxify and prime Nrf2 responses
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Functional Phytotherapy
5. Enhance nerve function• restore healthy nervous system function• improve sleep quality and time asleep
6. Improve circulatory flow• macrocirculation and blood quality• microcirculation and endothelial health• promote healing
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Functional Phytotherapy
7. Eliminate dysbiosis and promote a healthy microbiome
8. Optimize digestive function
9. Optimize and balance immune function
10. Eliminate chronic inflammation response
38Image: Tony Webster/ https://www.flickr.com/photos/diversey/17424310262
Functional Phytotherapy
11. Improve and enhance natural barriers: • gastric acid and gut wall
barrier• respiratory• skin
12. Address metabolic imbalances
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Bone K, Mills S. Principles and Practice of Phytotherapy 2nd Edition, 2013, Elsevier, Edinburgh
Right Targets:Lead to Right Protocols
Concluding Remarks
• Even a novice can achieve remarkable results with symptom-based prescribing, especially if using herbs that deliver in formulations with inbuilt clinical experience
• The next step is functional phytotherapy: 12 core strategies and 5 key principles, with some introductory examples, have been outlined
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