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AHG Professional Herbalist Training Webinars Presents:
Herbal Pharmacology: Case Based Studies with Guido Masé, RH (AHG)
Hosted by Anna Claire LottiAHG Education Coordinator
AHG Professional Herbalist Training Webinar Sponsors
To become a webinar sponsor contact www.americanherbalistsgsuild.com
Guido Masé RH(AHG)
*A case-based approach
Part IV
*Tissue-level activity
Central nervous system
Peripheral nervous system
Receptor / enzyme interaction
Lymphatic channels / Immune cells
Cardiac effects
Alkaloidal activity on S/A node
Hepatic effects
Hormone metabolism / enzyme interaction
Toxicity
Central effects (limbic, frontal, default action network)Peripheral effects (vanilloid receptors, chemosensing receptors)
Peripheral nervous system:
Sensory receptors (TRPV-1) aka vanilloid receptors
(examples of receptor modulation)
Cardiac muscle depolarization (Activation of contraction)
Cardiac activity – alkaloids (and cardio glycosides)
Lymphatic channels and immune system: innate immune activation / conversation, helper T cell modulation
Steroid dehydrogenase binding pocket
Steroid hormone metabolism (cortisol/cortisone)Also occurs in the kidney
Male, 38 years old
Received diagnosis of “prurigo nodularis”, body-wide itching characterized by widespread lesions that can be open
Of unknown etiology – usually tied to stress, itch-scratch cycle
Diet is good, GI habits regular, but anxiety level high!
Sleep, cardiovascular function normal – unless sleep is disrupted by itching (1-2 nights / week)
Constitutional notes:
Slender, very fidgety, scattered
Easily startled, constant motion
Somewhat dry
Potentially applicable chemical classes:
Volatile oils
Piperidine alkaloids – capsaicin (really a pseudo-alkaloid)
Steroidal saponins (adaptogenic effect)
Constitutional notes:
Need central nervous system support
Need “vata-pacifying” oil - sesame
Potentially applicable chemical classes:
Volatile oils
Cadinene – Scutellaria lateriflora
Yaghmai, M. S. Volatile constituents of Scutellaria lateriflora L Flavour and Fragrance Journal, John Wiley & Sons, Ltd., 1988, 3, 27-31
Potentially applicable chemical classes:
Piperidine (psuedo)alkaloids
Capsaicin – Capsicum spp
Ständer S, Luger T, Metze D. Treatment of prurigo nodularis with topical capsaicin. J Am Acad Dermatol. 2001 Mar;44(3):471-8.
Potentially applicable chemical classes:
Steroidal saponins
Panax quinquefolius
Kim TW, Choi HJ, Kim NJ, Kim DH. Anxiolytic-like effects of ginsenosides Rg3 and Rh2 from red ginseng in the elevated plus-maze model. Planta Med. 2009 Jun;75(8):836-9.
Male, 38 years old
Recommendations:
Topical capsaicin cream .025% TID if possible
Scutellaria 60ml, Panax 60ml 5ml TID
Sesame oil (raw) topically after shower
… 24 hours …
“You are crazy and torturing me!!!”
… 72 hours …
“The itching is gone!”
… 1 week …
“I will need more of the tincture formula.”
Lesions fading slowly, much improved
Female, 59 years old
Episodes of cardiac tamponade, uncertain etiology
Heart weakened: hypotension, fatigue, irregular rhythms
Otherwise extremely healthy, moderately active, good food including lots of hawthorn already
Constitutional notes:
Cool – unexpectedly so
Irregularity noticeable in a weak pulse
Very, very easy fatigability (new to her)
Potentially applicable chemical classes:
Quinolizidine alkaloids – sparteine e.g.
Bioflavonoids
Constitutional notes:
Fatigue is secondary to heart weakness
Potentially applicable chemical classes:
Quinolizidine alkaloid
Sparteine – Cytisus scoparius
M Raschack. Actions of sparteine and sparteine derivatives on the heart and circulation. Arzneimittel-Forschung, 1974
Female, 59 years old
Recommendations:
Fresh Scotch Broom flower extract, 10 gtt BID
Continue with high flavonoid (catechin) intake:
Hawthorn, blueberries
… 3 weeks …
Mild improvement in energy.
Noticeably more regular pulse
… 6 weeks…
Energy better, but improvement has stalled
Consider: adaptogens?
Ashwagandha / Rhodiola / Panax?
Trauma?
Post-traumatic stress disorder?
Anxiety associated with terminal disease?
Intractable depression?
Substance abuse/addiction?
- pattern-breaking (“default-mode network”)
Openness, creativity, meaning, happiness
Persistent changes from one dose
Roland GriffithsJohns Hopkins
Psilocybin: oceanic boundlessness, fear of ego dissolution, visualsFear in over 1/3 of participants, but significant benefits in depression, PTSD, anxiety, addiction
Griffiths, Roland R., et al. "Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance.” Psychopharmacology 187.3 (2006): 268-283.
Entheogens
Roland GriffithsJohns Hopkins
Psilocybin: increase in “openness” domain – clinically observed, reported by family/friends @ 6mo follow-up
MacLean, Katherine A., Matthew W. Johnson, and Roland R. Griffiths. "Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness." Journal of Psychopharmacology 25.11 (2011): 1453-1461.
Also:
Griffiths et al 2008: 14 month follow-upGriffiths, Grob et al 2013: anxiety + cancer
Entheogens
Roland GriffithsJohns Hopkins
Good review of overall effects of psilocybin on mental health:Griffiths, Roland R., and Charles S. Grob. "Hallucinogens as medicine."Scientific American 303.6 (2010): 76-79.
Johnson, Matthew W., et al. "Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction." Journal of Psychopharmacology (2014): 0269881114548296.
Experiment on tobacco cessation.80% stayed quit at 6mo follow-up….after one session!
Entheogens
Robin L Carhart-Harris (Imperial College, London)Clinical trial in the Lancet
One of the first prospective trials for psilocybin in cases of depression that didn’t respond to treatment.
Carhart-Harris, Robin L, et al. " Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study." The Lancet: Psychiatry (2016): pre-publication
12 patients. Two sessions, with escalatingdose of psilocybin.All patients reported anxiety during onset.All patients showed improvement at:1 week and 3 months in:depression, anxiety, anhedonia
Entheogens
Potential mechanisms for indole alkaloids:
- Increased DOPA re-uptake- 5-HT2A receptor hyper-excitability?
- prefrontal cortex, other cortical areas (<5% overall neurons)- Once excited, spread to other cortical areas
Openness, creativity, meaning, happinessPersistent changes from one dose
Martin, David A., and Charles D. Nichols. "Psychedelics Recruit Multiple Cellular Types
and Produce Complex Transcriptional Responses Within the Brain."
EBioMedicine 11 (2016): 262-277.
Potential mechanisms for indole alkaloids:
- Decreased activity in the default mode network- Pre-frontal cortex, medial temporal cortex, hippocampus and
limbic system- Sense of self, others, and emotion
Openness, creativity, meaning, happinessPersistent changes from one dose
Carhart-Harris, Robin L., et al. "Neural correlates of the psychedelic state as determined
by fMRI studies with psilocybin." Proceedings of the National Academy of Sciences
109.6 (2012): 2138-2143.
Indole alkaloids:
Psilocybin (Psilocybe cubensis)
Indole alkaloids:
Psilocybin (Psilocybe cubensis)
Ibogaine
Serotonin
From 1979, Japan, 2 cases of pseudoaldosteronism
Women aged 68 and 71
275mg to 550mg glycyrrhizin for 1.5 to 6 months (6-12g root)
Results: hypertension, elevated plasma sodium, disruption of renin-aldosterone system, edema
Effects continued for 1 month after discontinuation, then slowly renormalized
TAKEDA, R.; MORIMOTO, S.; UCHIDA, K.; NAKAI, T.; MIYAMOTO, M.; HASHIBA, T.; YOSHIMITSU, K.; KIM, K. S. & MIWA, U. Prolonged Pseudoaldosteronism Induced by Glycyrrhizin. EndocrinologiaJaponica, 1979, 26, 541-547
TAKEDA, R.; MORIMOTO, S.; UCHIDA, K.; NAKAI, T.; MIYAMOTO, M.; HASHIBA, T.; YOSHIMITSU, K.; KIM, K. S. & MIWA, U. Prolonged Pseudoaldosteronism Induced by Glycyrrhizin. EndocrinologiaJaponica, 1979, 26, 541-547
TAKEDA, R.; MORIMOTO, S.; UCHIDA, K.; NAKAI, T.; MIYAMOTO, M.; HASHIBA, T.; YOSHIMITSU, K.; KIM, K. S. & MIWA, U. Prolonged Pseudoaldosteronism Induced by Glycyrrhizin. EndocrinologiaJaponica, 1979, 26, 541-547
TAKEDA, R.; MORIMOTO, S.; UCHIDA, K.; NAKAI, T.; MIYAMOTO, M.; HASHIBA, T.; YOSHIMITSU, K.; KIM, K. S. & MIWA, U. Prolonged Pseudoaldosteronism Induced by Glycyrrhizin. EndocrinologiaJaponica, 1979, 26, 541-547
Male, 20 years old
Post-mononucleosis: weak, fatigued, experiences recurrent upper respiratory infection. EBV infection Sx began 3 mo ago
Generally healthy, fit, eats well. Occasional tobacco.
Hypersensitivity developing: chemicals, cleaners, laundry –with runny nose, itchy eyes
Constitutional notes: some yellowing
signs on tongue, occasional orbital
headache
Potentially applicable chemical classes:
Triterpenes (medicinal mushrooms)
Steroidal saponins (adaptogenic / immunologic effect)
Polysaccharides
[potentially, also, other cases: Echinacea/Hyssop/Baptisia 2wk]
Constitutional notes:
Need hepatic support?
Potentially applicable chemical classes:
Triterpenoids (steroidal) – from medicinal mushrooms
Ganoderma lucidum
Lin JY, Chen ML, Lin BF. Ganoderma tsugae in vivo modulates Th1/Th2 and macrophage responses in an allergic murine model. Food Chem Toxicol. 2006 Dec;44(12):2025-32.
Potentially applicable chemical classes:
Steroidal saponins
Panax quinquefolius
Luo YM, Cheng XJ, Yuan WX. Effects of ginseng root saponins and ginsenoside Rb1 on immunity in cold water swim stress mice and rats. Zhongguo Yao Li Xue Bao. 1993 Sep;14(5):401-4.
Potentially applicable chemical classes:
Flavonolignans
Silymarin – Silybum marianum
Bakhshaee M, Jabbari F, Hoseini S, Farid R, Sadeghian MH, Rajati M, Mohamadpoor AH, Movahhed R, Zamani MA. Effect of silymarin in the treatment of allergic rhinitis. OtolaryngolHead Neck Surg. 2011 Dec;145(6):904-9.
Male, 20 years old
Recommendations:
Astragalus root powder, 10g QD mixed with nut butter/honey
Tincture of 30ml Ganoderma, 90ml Panax. 5ml BID
Ground Silybum seed, 5g BID mixed with cooked grains
… 2 weeks …
1 recurrence of fever, 36 hours
Energy improving (slowly)
Tongue clear
… 6 weeks …
Much better. Back to work full-time,
exercise regime restarted
Consider your level of familiarity with the following concepts
Epithelial effects:What tissues?What actions?Botanical examplesRelevant constituents
Endothelial effects:Endothelial surfaceVascular / arteriolar / capillary smooth muscleBotanical examplesRelevant constituents
Consider your level of familiarity with the following concepts
Immunologic effects
Primary area(s) of influence from botanicals
Relevant constituents
Lymphatic effects
Role of coumarins
Fluid retention and the kidney
Coumarins and blood clotting
Consider your level of familiarity with the following concepts
“Acupharmacological” effects
Useful model for understanding oral dosing
Autonomic nervous system’s role
Protein/receptor-mediated effects
Cell surface
Nuclear
Transcription regulation
Metabolic enzymes (Liver phase 1, steroid) + consequences
Consider your level of familiarity with the following concepts
EpigeneticsMethylation of DNA backboneAcetylation / modification of histonesNotable phytochemical constituentsConsequences (note: phyto “antioxidants”? estrogens?)
Nervous systemAcupharmacologyLimbic system modulationPeripheral / Central receptor influencesNeuromuscular polarization effects
Consider your level of familiarity with the following concepts
Pharmacokinetics (how the body affects constituents)
Glycosylation / deglycosylation + relevant molecules
Absorption enhancement
Mechanical “trapping” in GI tract
Motility modification
Hepatic metabolic enzymes (Phase 1 and 2)
Route(s) of excretion
Consider your level of familiarity with the following concepts
Toxicity
Pyrrolizidine alkaloids
Cardioactive alkaloids / glycosides
Tropane alkaloids
Emesis through irritation (alkaloids, saponins)
Potential interactions
Additive synergy
Hepatic metabolism
Guido Masé RH(AHG)
aradicle.blogspot.com
Thank you!!