It's my passion to educate people on the value and joys of medical aromatherapy. To that end, it's been a busy week, so you'll excuse my delay in posting a blog.
I lectured at PANGEA, 2008 in New York City. I participated in a panel discussion on natural first aid treatments for the family. It was a fantastic panel and I was honored to sit with them. There was Aviva Jill Rohm, an herbalist and midwife of over 20 years experience, now in her final year of medical school at Yale University School of Medicine. She spoke about herbal approaches to first aid. There was Donielle Wilson, a superb naturopath and homeopathy. She spoke about homeoapthy for first aid. There was David Riley, a medical doctor, very fine homeopath and pioneer in integrative medicine (and yoga instructor!). He was the moderator and added some gems about homeopathy...And there was me. I spoke about aromatherapy and first aid.
As life tends to have that literary, ironic hue to it times, my son needed some first aid the night I was preparing for my talk. He got a black eye. It was only 15 minutes after his face was hit with the lid of a garbage can with its own agenda it his eye was swollen and bruised.
I quickly made a cold compress using hydrolats (floral waters). Hydrolats are the water-extract of plants that come from making essential oils ( you could say that essential oils are the oil-based extract left from making hydrolats). Hydrolats are the "other aromatherapy." Rose water is the best known hydrolat.
I took a sturdy paper towel and liberally soaked it with helichrysum and pine hydrolats. I put it on his face and put a bag of ice over his eye. After 20 minutes we took it off and looked at his face. He was so upset! The bruise had completely subsided and the swelling was greatly improved. He said, "Noooooo! I wanted a black eye on Monday to show my friends. Dad, now I won't look like I got hurt!" After the initial compress, we started arnica homeopathic and continued the helichrysum and pine internally--1 tablespoon combined with 4 oz of water twice per day. When I returned from New York 4 days later there was not even a trace of bruising or swelling.
This story is a great example of how medical aromatherapy is an important part but not the ONLY treatment modality to be used. It's just that it's very convenient and easy to easy and incredibly effective, and, with acute injury, it works faster than any other treatment I know.
Saturday, November 22, 2008
Wednesday, November 12, 2008
Medical Quality Essential Oils
Medical aromatherapy is the science of using essential oils for health and healing. Medical aromatherapy has a 5000 year old history going back to the ancient Egyptians. Internal usage of essential oils is a safe and effective means of curing many illnesses and dysfunctions in the body, in children and adults if a safe concentration (1-10%) of the right essential oils is used. But most importantly, the right quality of essential oil must be used--medical quality.
Listen to a short, 3 minute discussion of medical quality essential oils here:
It's really important to know the quality of your essential oils because many companies that use essential oils in their products, including many reputable companies, do not know how to tell a quality essential oil from an adulterated one. You can, though with a sensitive nose.
When you smell an essential oil or a shampoo, soap, etc. that claims to have "pure" essential oils, pay attention to the feeling around your jaw and up the side of your head. If your jaw tightens up, or you feel a slight headache, or like there is a vice around your head, that essential oils has been adulterated--cut with a synthetic version of one of the naturally occurring compounds in that oil to "boost" the scent.
The most common oils they do this too are:
Now, I know that you know that the big guys use this stuff shamelessly in their "kids" lines, but I'm very disappointed to see that many of the "eco" and "green" companies fall trap to the Medusa of fragrance oils--even after they spent money using cheap essential oils.
Caveat emptor. Read your labels carefully and be well.
PS: BPA is in baby bottles, water bottles and lots of other products. Please look for BPA free products whenever possible.
Listen to a short, 3 minute discussion of medical quality essential oils here:
It's really important to know the quality of your essential oils because many companies that use essential oils in their products, including many reputable companies, do not know how to tell a quality essential oil from an adulterated one. You can, though with a sensitive nose.
When you smell an essential oil or a shampoo, soap, etc. that claims to have "pure" essential oils, pay attention to the feeling around your jaw and up the side of your head. If your jaw tightens up, or you feel a slight headache, or like there is a vice around your head, that essential oils has been adulterated--cut with a synthetic version of one of the naturally occurring compounds in that oil to "boost" the scent.
The most common oils they do this too are:
- Lavender
- Jasmine
- Neroli
- Citrus oils (Orange, Grapefruit, Lemon, Lime, Tangerine, Bergamot, etc.)
- Clove
- fragrance
- parfum
- fragrance oil.
Now, I know that you know that the big guys use this stuff shamelessly in their "kids" lines, but I'm very disappointed to see that many of the "eco" and "green" companies fall trap to the Medusa of fragrance oils--even after they spent money using cheap essential oils.
Caveat emptor. Read your labels carefully and be well.
PS: BPA is in baby bottles, water bottles and lots of other products. Please look for BPA free products whenever possible.
Tuesday, November 11, 2008
Free at last: a short story about heart transplantation
I am posting this story about a patient I took care of while I was at Stanford University, where heart transplantation was first performed in humans. I am posting this as a follow up to my previous posting about Hannah Jones, the 13 year old girl in England who turned down a heart transplant due to a failing heart from the side effects of chemotherapy (Major minor: children's right to chose).
Free at last
Snip. She cut another paisley triangle, neatly stacking it next to the calico squares. “It keeps me busy,” she explained as I walked in to glance at the monitor. “I’m making a quilt for my first grandchild born just last week. I haven’t seen him yet.” She looked at her son, up at the monitor, then at me. It was almost midnight and I had come in to check on Luke before midnight rounds. His blood pressure was still too low but hadn’t changed in the last few hours. Not better, not worse; stably unstable. This oxymoron made sense in my world. It just did.
The last of eight children, he was the baby, the tall, pale one who always stood next to his mother in family pictures. He needed a heart and double lung transplant to survive. They had come from a small town in Nebraska to free him from a life of illness. When he was transplanted, Luke’s mother was ecstatic. But her joy lay in the sadness of others—she knew what had to happen for her son to have received a “donated” heart—and that troubled her. She saw two teenagers who had received hearts around the same time as Luke leave the ICU after a few days while her son languished here for weeks. Her sadness lay in the joy of others and that troubled her too—but to that she’d never admit.
It had been a rocky course from the beginning for Luke. His kidneys shut down from low blood pressure and infections. He was hooked up to a dialysis machine on his second day back from the operation. He was extubated, re-intubated, re-extubated, and intubated over and over again with a breathing tube because he was not even strong enough to breathe on his own and have his heart pump at the same time. Then he became infected again with God-knows-what. It wasn’t responding to any class of antibiotic we had on hand.
“We want everything done. But we don’t want him to suffer.” His mother would say to me. At this point, they were mutually exclusive requests, but that made sense in her world. It just did.
She and her husband came to learn our lingo and could infer a lot from the monitors and my face without us needing to utter words. They learned the semiotics of a raised eyebrow and stroked beard with and without cocked head. A glance at the vitals flow sheet with a “humph” was the most intolerable and I found a brief commentary to be de rigueur to put them at ease.
With each successive week, we spoke less and less about monitors and medications. Instead, at their request, we started talking basic physiology. I found myself explaining nine years of medical education in 15 minute sermons using metaphors of pipes, pumps and flowers. Then, our conversations became personal. I was seeing them more than my own wife and children and they hadn’t seen their other seven children or parishioners in weeks. We were both working shifts in order to take care of Luke. They alternated six hours on, six hours off at the bedside. As for myself, I was doing thirty hours on, eighteen hours off.
Setting her scissors down, she began to tell me how difficult it had been to raise eight children and be a minister’s wife. It was a life of sacrifice and she was content to live it only because she saw it as God’s will. It was a life lived in denial of comfort or privacy. She could never call her husband her own because he was wedded to his parish too. I laughed and told her that a physician’s wife had it no better.
The whirring of the dialysis machine filled a momentary silence; then she continued.
“I miss my home so badly, doctor. I miss having just one moment of privacy. Once, last week, I just wanted to go somewhere and cry. All the sleep rooms were occupied, someone was in the bathroom, and the family lounge was full of people. My husband came up to me and put a blanket over our heads and said, ‘Here’s our private space.’ And I cried until I couldn’t cry any more.”
Our conversation drifted to religion and she began complaining about those “liberal Christians”. I wondered if she knew or cared that I was Muslim. It didn’t matter to me either way. She was a mother. I was a father. That was commonalty enough for me. Birth has no creed, illness has no dogma, and sorrow is the universal paean of death.
She gathered up the strips of clothe and turned to me like a school girl at penance. “Doctor, I feel that Luke is suffering. I feel that he’s trapped in there. We thought that this transplant would free him from a life of constantly being ill.” I found myself playing minister and counseled her to be patient, saying “It will, it will.”
The next morning, considering Luke’s condition and his parent’s concern for his suffering, the decision was made to de-escalate care, a euphemism for “pulling the plug”. Curtains drawn, the door was closed and the cacophony of the ICU gave way to a heavy silence. One by one the machines were turned off until the whirs and beeps were replaced by whimpers and sighs. The breathing tube was removed. The pressure medicines stopped. Heavily sedated, Luke lay in a state between two states. Like snow drifting in a waning December wind, he laid somewhere between heaven and earth. After 18 years of suffering, 2 weeks of waiting, 3 weeks of struggle and 4 minutes of peace, it was over.
Bereft of clerical counsel, I hugged the reverend, letting the tears fall from his face unto my shoulder. Consoling his mother I said, “The suffering’s over. He’s free. Free at last.”
Free at last
Snip. She cut another paisley triangle, neatly stacking it next to the calico squares. “It keeps me busy,” she explained as I walked in to glance at the monitor. “I’m making a quilt for my first grandchild born just last week. I haven’t seen him yet.” She looked at her son, up at the monitor, then at me. It was almost midnight and I had come in to check on Luke before midnight rounds. His blood pressure was still too low but hadn’t changed in the last few hours. Not better, not worse; stably unstable. This oxymoron made sense in my world. It just did.
The last of eight children, he was the baby, the tall, pale one who always stood next to his mother in family pictures. He needed a heart and double lung transplant to survive. They had come from a small town in Nebraska to free him from a life of illness. When he was transplanted, Luke’s mother was ecstatic. But her joy lay in the sadness of others—she knew what had to happen for her son to have received a “donated” heart—and that troubled her. She saw two teenagers who had received hearts around the same time as Luke leave the ICU after a few days while her son languished here for weeks. Her sadness lay in the joy of others and that troubled her too—but to that she’d never admit.
It had been a rocky course from the beginning for Luke. His kidneys shut down from low blood pressure and infections. He was hooked up to a dialysis machine on his second day back from the operation. He was extubated, re-intubated, re-extubated, and intubated over and over again with a breathing tube because he was not even strong enough to breathe on his own and have his heart pump at the same time. Then he became infected again with God-knows-what. It wasn’t responding to any class of antibiotic we had on hand.
“We want everything done. But we don’t want him to suffer.” His mother would say to me. At this point, they were mutually exclusive requests, but that made sense in her world. It just did.
She and her husband came to learn our lingo and could infer a lot from the monitors and my face without us needing to utter words. They learned the semiotics of a raised eyebrow and stroked beard with and without cocked head. A glance at the vitals flow sheet with a “humph” was the most intolerable and I found a brief commentary to be de rigueur to put them at ease.
With each successive week, we spoke less and less about monitors and medications. Instead, at their request, we started talking basic physiology. I found myself explaining nine years of medical education in 15 minute sermons using metaphors of pipes, pumps and flowers. Then, our conversations became personal. I was seeing them more than my own wife and children and they hadn’t seen their other seven children or parishioners in weeks. We were both working shifts in order to take care of Luke. They alternated six hours on, six hours off at the bedside. As for myself, I was doing thirty hours on, eighteen hours off.
Setting her scissors down, she began to tell me how difficult it had been to raise eight children and be a minister’s wife. It was a life of sacrifice and she was content to live it only because she saw it as God’s will. It was a life lived in denial of comfort or privacy. She could never call her husband her own because he was wedded to his parish too. I laughed and told her that a physician’s wife had it no better.
The whirring of the dialysis machine filled a momentary silence; then she continued.
“I miss my home so badly, doctor. I miss having just one moment of privacy. Once, last week, I just wanted to go somewhere and cry. All the sleep rooms were occupied, someone was in the bathroom, and the family lounge was full of people. My husband came up to me and put a blanket over our heads and said, ‘Here’s our private space.’ And I cried until I couldn’t cry any more.”
Our conversation drifted to religion and she began complaining about those “liberal Christians”. I wondered if she knew or cared that I was Muslim. It didn’t matter to me either way. She was a mother. I was a father. That was commonalty enough for me. Birth has no creed, illness has no dogma, and sorrow is the universal paean of death.
She gathered up the strips of clothe and turned to me like a school girl at penance. “Doctor, I feel that Luke is suffering. I feel that he’s trapped in there. We thought that this transplant would free him from a life of constantly being ill.” I found myself playing minister and counseled her to be patient, saying “It will, it will.”
The next morning, considering Luke’s condition and his parent’s concern for his suffering, the decision was made to de-escalate care, a euphemism for “pulling the plug”. Curtains drawn, the door was closed and the cacophony of the ICU gave way to a heavy silence. One by one the machines were turned off until the whirs and beeps were replaced by whimpers and sighs. The breathing tube was removed. The pressure medicines stopped. Heavily sedated, Luke lay in a state between two states. Like snow drifting in a waning December wind, he laid somewhere between heaven and earth. After 18 years of suffering, 2 weeks of waiting, 3 weeks of struggle and 4 minutes of peace, it was over.
Bereft of clerical counsel, I hugged the reverend, letting the tears fall from his face unto my shoulder. Consoling his mother I said, “The suffering’s over. He’s free. Free at last.”
A major minor: children's right to choose their medical fate
The Associated Press reported today that a 13 year old British girl, Hannah Jones, was granted the right to refuse a heart transplant. (Watch an interview with her here) She was diagnosed with AML, a form of leukemia when she was 4 year old. The chemotherapy she received has a known side effect of causing cardiomyopathy--a weakness of the heart muscle--which she did in fact develop. The heart was declining in function to the point that her medical team recommended a heart transplant.
For a 70 year old with a failing heart, a heart transplant that extends their quantity and quality of life for 3 years or 5 years can be a significant and worthwhile intervention. But what about in children? Children outlive their heart transplants and have to be retransplanted over and over again if they don't die of cancer from the immunosuppressive drugs, or, from arrythmias or infections. (I've seen all of this happen to these sweet children). Of course, many leave in a few days from the hospital and live 10 worry free years before they experience the least bit of trouble, and the amazing dedication of the transplant surgeons, nurses, immunologists and everyone else must be recognized.
Working in the intensive care unit with these patients, the decision can be agonizing. Sometimes, the children don't survive the first week or two after the operation and they die in the hospital, often times alone, or, away from most of their friends and family. You can read a short story I wrote about such a patient called "Free at least" in the next blog. Make sure you have a hanki ready.
The case of Ms. Hannah Jones went to court because one physician insisted that she have the transplant despite the family's careful and thoughtful consultation with their medical team and Hannah's clear articulation of her reasons against the operation.
When we speak about the welfare of the child we need to consider not only their physical welfare, but their emotional, spiritual and family welfare too. In my experience, children with life-long illnesses, like cystic fibrosis, cancer, and congenital heart disease, are wise beyond their years in understanding the precarious nature of life and death and the difference between prolonging life and prolonging death.
In these situations, where the child has a terminal or life long illness, their life is not imminently at risk, they are able to understand the consequences of their decision, and it is not being made at the request of the parents or due to financial hardships, the child's request to not continue medical treatment in light of other aspects of their well-being should be respected.
These are not easy decisions, and tears stream my face as I think of the families I worked over the years whose children have made those difficult decisions and the losses that the parents carry with them all their lives. Sometimes, when things don't go as suspected, the medical team tries to resuscitate the child and in some hospitals, parents are not allowed to be present (although this is rare in the pediatric intensive care unit at this point). Even if parents can watch, they are just watching their child die with no ability to hold their hand or say "I love you."
The only thing worse than a child dieing is a child dieing without dignity, without their parents holding them and loving them for one final embrace. That's why it's so important that children like Hannah be allowed to express their understanding of their illness and discuss it with her parents and doctors before a tragic downturn occurs.
You can read my articles on pediatric medical ethics from the Islamic perspective here and on death rituals when a children die here.
For a 70 year old with a failing heart, a heart transplant that extends their quantity and quality of life for 3 years or 5 years can be a significant and worthwhile intervention. But what about in children? Children outlive their heart transplants and have to be retransplanted over and over again if they don't die of cancer from the immunosuppressive drugs, or, from arrythmias or infections. (I've seen all of this happen to these sweet children). Of course, many leave in a few days from the hospital and live 10 worry free years before they experience the least bit of trouble, and the amazing dedication of the transplant surgeons, nurses, immunologists and everyone else must be recognized.
Working in the intensive care unit with these patients, the decision can be agonizing. Sometimes, the children don't survive the first week or two after the operation and they die in the hospital, often times alone, or, away from most of their friends and family. You can read a short story I wrote about such a patient called "Free at least" in the next blog. Make sure you have a hanki ready.
The case of Ms. Hannah Jones went to court because one physician insisted that she have the transplant despite the family's careful and thoughtful consultation with their medical team and Hannah's clear articulation of her reasons against the operation.
When we speak about the welfare of the child we need to consider not only their physical welfare, but their emotional, spiritual and family welfare too. In my experience, children with life-long illnesses, like cystic fibrosis, cancer, and congenital heart disease, are wise beyond their years in understanding the precarious nature of life and death and the difference between prolonging life and prolonging death.
In these situations, where the child has a terminal or life long illness, their life is not imminently at risk, they are able to understand the consequences of their decision, and it is not being made at the request of the parents or due to financial hardships, the child's request to not continue medical treatment in light of other aspects of their well-being should be respected.
These are not easy decisions, and tears stream my face as I think of the families I worked over the years whose children have made those difficult decisions and the losses that the parents carry with them all their lives. Sometimes, when things don't go as suspected, the medical team tries to resuscitate the child and in some hospitals, parents are not allowed to be present (although this is rare in the pediatric intensive care unit at this point). Even if parents can watch, they are just watching their child die with no ability to hold their hand or say "I love you."
The only thing worse than a child dieing is a child dieing without dignity, without their parents holding them and loving them for one final embrace. That's why it's so important that children like Hannah be allowed to express their understanding of their illness and discuss it with her parents and doctors before a tragic downturn occurs.
You can read my articles on pediatric medical ethics from the Islamic perspective here and on death rituals when a children die here.
Monday, November 10, 2008
PANGEA lecture: Aromatherapy for First Aid
I'll be speaking in New York City on November 15, 2008 at the Marriott Downtown in Manhattan. The topic is Natural treatments for First Aid: a panel discussion. I'll be speaking about the role of essential oils and medical aromatherapy. Come back and look for my article, which I'll post on my blog, and, here.
The venue is PANGEA, a pediatric integrative medicine conference for healthcare practitioners who take care of children, including medical doctors, naturopaths, chiropracters, homeopaths, herbalists and others.
Go here to learn about the conference, here to learn about the parent organization, the Integrative Pediatric Council. If you are a parent, you can read my friend and founder of the IPC, Dr. Larry Rosen's fantastic blog and find an integrative pediatrician for your child.
Kamyar Hedayat
The venue is PANGEA, a pediatric integrative medicine conference for healthcare practitioners who take care of children, including medical doctors, naturopaths, chiropracters, homeopaths, herbalists and others.
Go here to learn about the conference, here to learn about the parent organization, the Integrative Pediatric Council. If you are a parent, you can read my friend and founder of the IPC, Dr. Larry Rosen's fantastic blog and find an integrative pediatrician for your child.
Kamyar Hedayat
Tuesday, November 4, 2008
Standardized Failure: A cautionary tale of standardized extracts
CONCERN
The trade paper, Natural Product Insider, published a report today, November 4, 2008, about the widespread adulteration of Ginkgo biloba supplements (75% of tested supplements). The adulteration came in the form of "boosting" the count of certain "active" compounds using other plant extracts instead of using high quality Ginkgo leaves.
Three factors came together to form the perfect storm. 1) Ginkgo has a well-deserved reputation for improving circulation and cognitive function. With an aging population in Western countries, the demand for Ginkgo has only grown. 2) The German Commission E, a sort of FDA for natural products, set minimum standards active compounds in Ginkgo extracts. Setting standards for natural products forces a dynamic growth cycles to conform to static demands, and 3) Unscrupulous manufacturers of raw material get on the band wagon to provide supplement makers with "what they want" at any cost. No comment.
EXAMINATION
Let's consider factor number 2: Standardization. The attempt to "standardize" plant products to contain a minimum amount of a certain "active" ingredient comes from an attempt to consider plants as drugs in their own right, control their quality and protect consumers to ensure that they receive a quality product.
All these goals are noble and important. Unfortunately, they represent a form of medical colonialism. Like the old colonial powers of the past, who made native people dress and eat and walk and think like them before they would "accept" them as being civilized or respectable, the predominant academic, scientific, industrial and legal organs of medicine insist on fitting natural products into their reductionist concepts of what the definition of "drug" before they will accept natural healing products as legitimate: the attitude of "I will tolerate you when I can control you."
According to this school of thought, a drug is a single compound that works at a single receptor site. The more of that compound you have, the more of an effect you will have. Time and time again, drug and supplement manufacturers have been surprised at the results. In the case of natural supplements, St. John's Wort for depression is a good example. Researchers jumped to conclusions about hypericin being the active compound in St. John's wort and hundreds of studies were performed using standardized extracts vs. anti-depressants. The studies had mixed results as far as St. John's Wort's effectiveness for mild depression. Currently, scientists think that maybe other compounds are "more active" than hypericin. This is the problem with following the fallacy of active compounds in plants.
In the case of synthetic drugs, Vioxx and Celebrex causing heart attacks, or statins increasing the risk for suicide, or in my sub-speciality of critical care, of nitric oxide inhibitors increasing death from septic shock are all good examples. The spectacular disasters in the form of loss of human life have come about due to a failure to create a holistic understanding of how the body works, why it works the way that it does and what the meaning of illness is.
The aggressiveness and forcefulness of synthetic medications--critical care relies on them for its very existence--is impressive for the extremes of disease. I am not proposing that synthetic drugs are all bad, or natural products are all good. Everything has its place. And sometimes, they have a place together. Read my research on essential oils in the intensive care unit here.
On the spectrum of illness, most people's health issues can be framed as sub-optimal vs. optimal, not disease vs. no disease. So, this idea of what a drug is is good in theory, but it does not match how the body works, or how plants work for that matter. Most people, most the time, need gentle recallibration, not sudden suppression or increase in bodily functions.
The body is a complex, dynamic organism which is not static and passive, waiting for Bayer to invent aspirin. It's a self-regulating, self-healing organism with multiple, redundant pathways of compensation. Plants are polymodal multichemical products--in other words, they have many compounds in them that work in many different ways. Plants have an "intelligence" about them in that they interact with the body and there is a "dance" a back and forth of subtle increases and decreases, of feedback and promotion which occurs.
It is a fallacy to say that one compound is the active compound in a drug, because many, many compounds do different things in the body. What is amazing about plants--and this holds true for essential oils--is that they often contain compounds which do the opposite of the intended effect of the plant, but to a smaller degree. They contain base compounds which can become active compounds if the body needs it, or, be flushed out of the system unused. Plants come with their own antidotes to lower the incidence of side effects and over doses. It would be like every capsule of Tylenol coming with its antidote for overdose, N-acetyl cysteine (NAC). If only humans were as smart as the natural world.
CASE OF AROMATHERAPY AND ESSENTIAL OILS
When you examine the research on essential oils, many interesting observations come to light. For example, there are many instances where the whole essential oil, say, of Clove (Syzygium aromaticum), is more effective than its "active" component in head to head studies for pain control even though the whole oil has less of the "active" component. More importantly, a single essential oil, again, say, clove, not only killls the bacteria, but is anti-inflammatory, stimulates the immune system, and increases emunctory organ activity and detoxification at the same time.
Drs. Jean Claude Lapraz and Christian Duraffourd in the 1970's performed experiments with essential oils and infectious disease to examine the efficacy of various chemical components of essential oils. They performed "aromatograms"--evaluation of the killing power of essential oils in the lab against certain bacteria. What they found was that in this case, oils like Oregano, Thyme ct. thymol, Clove and Cinnamon were the most effective against a range of bacteria. This is to be expected because of the high amount of phenolic compounds in them.
However, much to their surprise, in clinical usage, "gentler" essential oils such as Thyme ct. linalool, lavender and geranium were more effective than the more "powerful" essential oils. The reason for this was that in the body, the essential oils not only directly killed bacteria, but stimulated the body's natural immunity in many different ways. In other words, it is the "terrain" of the body--how the body is functioning or malfunctioning--that determines how effective an appropriately chosen plant product is, not the specific amount a particular compound.
Others studies have shown that "gentler" essential oils used together have an amazing synergy with a significant antibacterial effect without the risk of the stronger compounds in essential oils like oregano.
CONCLUSION
Plant products--phytotherapy--involves complex, dynamic, multi-chemical substances that interact with an equally complex and dynamic living organism--your body. There is no need to standardize natural products to certain levels of this compound or that compound because the whole plant, in the whole body, will have the effect that it needs to have, which is greater than its effect on one cell receptor in the body. Standardizing natural supplements only increases the tendency towards fraud and deception to meet an artificial standard of "potency" and pigeon-holes plants into the category of synthetic pharmaceuticals.
To read more about essential oils and review their clinical effects, go here. for general articles, and here for scientific articles.
The trade paper, Natural Product Insider, published a report today, November 4, 2008, about the widespread adulteration of Ginkgo biloba supplements (75% of tested supplements). The adulteration came in the form of "boosting" the count of certain "active" compounds using other plant extracts instead of using high quality Ginkgo leaves.
Three factors came together to form the perfect storm. 1) Ginkgo has a well-deserved reputation for improving circulation and cognitive function. With an aging population in Western countries, the demand for Ginkgo has only grown. 2) The German Commission E, a sort of FDA for natural products, set minimum standards active compounds in Ginkgo extracts. Setting standards for natural products forces a dynamic growth cycles to conform to static demands, and 3) Unscrupulous manufacturers of raw material get on the band wagon to provide supplement makers with "what they want" at any cost. No comment.
EXAMINATION
Let's consider factor number 2: Standardization. The attempt to "standardize" plant products to contain a minimum amount of a certain "active" ingredient comes from an attempt to consider plants as drugs in their own right, control their quality and protect consumers to ensure that they receive a quality product.
All these goals are noble and important. Unfortunately, they represent a form of medical colonialism. Like the old colonial powers of the past, who made native people dress and eat and walk and think like them before they would "accept" them as being civilized or respectable, the predominant academic, scientific, industrial and legal organs of medicine insist on fitting natural products into their reductionist concepts of what the definition of "drug" before they will accept natural healing products as legitimate: the attitude of "I will tolerate you when I can control you."
According to this school of thought, a drug is a single compound that works at a single receptor site. The more of that compound you have, the more of an effect you will have. Time and time again, drug and supplement manufacturers have been surprised at the results. In the case of natural supplements, St. John's Wort for depression is a good example. Researchers jumped to conclusions about hypericin being the active compound in St. John's wort and hundreds of studies were performed using standardized extracts vs. anti-depressants. The studies had mixed results as far as St. John's Wort's effectiveness for mild depression. Currently, scientists think that maybe other compounds are "more active" than hypericin. This is the problem with following the fallacy of active compounds in plants.
In the case of synthetic drugs, Vioxx and Celebrex causing heart attacks, or statins increasing the risk for suicide, or in my sub-speciality of critical care, of nitric oxide inhibitors increasing death from septic shock are all good examples. The spectacular disasters in the form of loss of human life have come about due to a failure to create a holistic understanding of how the body works, why it works the way that it does and what the meaning of illness is.
The aggressiveness and forcefulness of synthetic medications--critical care relies on them for its very existence--is impressive for the extremes of disease. I am not proposing that synthetic drugs are all bad, or natural products are all good. Everything has its place. And sometimes, they have a place together. Read my research on essential oils in the intensive care unit here.
On the spectrum of illness, most people's health issues can be framed as sub-optimal vs. optimal, not disease vs. no disease. So, this idea of what a drug is is good in theory, but it does not match how the body works, or how plants work for that matter. Most people, most the time, need gentle recallibration, not sudden suppression or increase in bodily functions.
The body is a complex, dynamic organism which is not static and passive, waiting for Bayer to invent aspirin. It's a self-regulating, self-healing organism with multiple, redundant pathways of compensation. Plants are polymodal multichemical products--in other words, they have many compounds in them that work in many different ways. Plants have an "intelligence" about them in that they interact with the body and there is a "dance" a back and forth of subtle increases and decreases, of feedback and promotion which occurs.
It is a fallacy to say that one compound is the active compound in a drug, because many, many compounds do different things in the body. What is amazing about plants--and this holds true for essential oils--is that they often contain compounds which do the opposite of the intended effect of the plant, but to a smaller degree. They contain base compounds which can become active compounds if the body needs it, or, be flushed out of the system unused. Plants come with their own antidotes to lower the incidence of side effects and over doses. It would be like every capsule of Tylenol coming with its antidote for overdose, N-acetyl cysteine (NAC). If only humans were as smart as the natural world.
CASE OF AROMATHERAPY AND ESSENTIAL OILS
When you examine the research on essential oils, many interesting observations come to light. For example, there are many instances where the whole essential oil, say, of Clove (Syzygium aromaticum), is more effective than its "active" component in head to head studies for pain control even though the whole oil has less of the "active" component. More importantly, a single essential oil, again, say, clove, not only killls the bacteria, but is anti-inflammatory, stimulates the immune system, and increases emunctory organ activity and detoxification at the same time.
Drs. Jean Claude Lapraz and Christian Duraffourd in the 1970's performed experiments with essential oils and infectious disease to examine the efficacy of various chemical components of essential oils. They performed "aromatograms"--evaluation of the killing power of essential oils in the lab against certain bacteria. What they found was that in this case, oils like Oregano, Thyme ct. thymol, Clove and Cinnamon were the most effective against a range of bacteria. This is to be expected because of the high amount of phenolic compounds in them.
However, much to their surprise, in clinical usage, "gentler" essential oils such as Thyme ct. linalool, lavender and geranium were more effective than the more "powerful" essential oils. The reason for this was that in the body, the essential oils not only directly killed bacteria, but stimulated the body's natural immunity in many different ways. In other words, it is the "terrain" of the body--how the body is functioning or malfunctioning--that determines how effective an appropriately chosen plant product is, not the specific amount a particular compound.
Others studies have shown that "gentler" essential oils used together have an amazing synergy with a significant antibacterial effect without the risk of the stronger compounds in essential oils like oregano.
CONCLUSION
Plant products--phytotherapy--involves complex, dynamic, multi-chemical substances that interact with an equally complex and dynamic living organism--your body. There is no need to standardize natural products to certain levels of this compound or that compound because the whole plant, in the whole body, will have the effect that it needs to have, which is greater than its effect on one cell receptor in the body. Standardizing natural supplements only increases the tendency towards fraud and deception to meet an artificial standard of "potency" and pigeon-holes plants into the category of synthetic pharmaceuticals.
To read more about essential oils and review their clinical effects, go here. for general articles, and here for scientific articles.
Monday, November 3, 2008
No one hangs themselves after smelling lavender: SSRI's and suicide
CONCERN
The supreme court is currently considering a case against the drug manufacturer Wyeth regarding product liability. At risk is the a consumer's ability to sue the makers of faulty goods or dangerous medication. The pharmaceutical industry has been notorious for its after-market cover-ups of clinical data which revealed that their products were ineffective at best, and dangerous at worst. While this is not what the particular court case is about, it does bring up an important point about pharmaceutical products and just how safe they are.
Products such as Vioxx and Celebrex come to mind, the block buster arthritis medicines that turned out to increase the risk of heart attacks. In the case of anti-depressants, these medications are being used in children in increasing numbers, despite the risk of suicide and mania.
RESPONSE
Medical aromatherapy, the clinical use of plant essential oils, offers hope for people struggling with minor depression or occasional mood swings. Forget whatever comes to mind when you hear the term aromatherapy, such as candles and bath salts. Medical aromatherapy uses REAL essential oils, not synthetic fragrance oils, to cure body, mind and soul.
Essential oils work in three ways:
1) The smell (olfactory) nerve in the nose connects directly to the deep part of the brain that controls all hormones (hypothalamus) and emotions (limbic system), instantaneously affecting everything from stress levels, to memory, to attention.
2) By inhaling the essential oils, they go through the lungs like gas anesthesia and enter the blood stream
3) Through the skin they enter the blood stream and affect cellular activity
4) By ingesting them, they enter the blood stream and effect cellular activity
EVIDENCE
For example, a number of clinical trials from around the world have shown that essential oils, and tincture extracts of plants (containing essential oils) are effective for depression when compared against standard pharmaceutical treatments (double-blind placebo control trials) with almost no side effects: lavender essential oil massage, citrus essential oils, lavender tincture, saffron tincture.
PRACTICAL SOLUTION
I find that a combination of medical quality essential oils is the most effective way to keep your mood up and treat mild depression. Internal usage of essential oils can be safe and effective when used under the guidance of a trained medical aromatherapist, or when using prediluted essential oils. In general, 1 drop of pure essential oils per day is more than enough for mild depression and can work in a short as 3-4 days. As with any medical condition, discuss it with your health care practitioner first and do not stop any current treatments abruptly. Depression lasting more than 6 weeks, or affecting your ability to work is more serious and can be treated with essential oils under the close supervision of a medical aromatherapist.
MORE INFORMATION
95% of serotonin is made in the gut, and 90% is used there for digestion, which is why many people with depression have digestive troubles--over-eating or under-eating. When serotonin levels are low in the brain, the gut sends some up to the brain in platelets to help it out. Lavender is a very good anti-depressant which also reduces stress levels and stress hormones without being sedating. It helps increase serotonin levels for the brain by reducing the use of serotonin in the gut.
Holy Basil, also known as Tulsi, is also very good and works by focusing the mind while relaxing the body. Holy basil seems to increase nor epinephrine levels.
Grapefruit gives a feeling of brightness and motivation while also increasing dopamine and nor epinephrine levels.
Clary sage is a good support for depression because it supports the adrenal gland to deal with stress and balances the nerves and hormones to bring stress levels down a notch.
Sweet Basil is also effective, but its strong after taste can be difficult to tolerate unless using a capsule. Even then, it should be diluted with olive oil and taken between meals.
CONCLUSION
No one ever hung themselves after smelling or ingesting lavender, unlike SSRI anti-depressants. For mild depression in children and adults, medical quality essential oils, inhaled, massaged or ingested can be effective with little to no side effects.
The supreme court is currently considering a case against the drug manufacturer Wyeth regarding product liability. At risk is the a consumer's ability to sue the makers of faulty goods or dangerous medication. The pharmaceutical industry has been notorious for its after-market cover-ups of clinical data which revealed that their products were ineffective at best, and dangerous at worst. While this is not what the particular court case is about, it does bring up an important point about pharmaceutical products and just how safe they are.
Products such as Vioxx and Celebrex come to mind, the block buster arthritis medicines that turned out to increase the risk of heart attacks. In the case of anti-depressants, these medications are being used in children in increasing numbers, despite the risk of suicide and mania.
RESPONSE
Medical aromatherapy, the clinical use of plant essential oils, offers hope for people struggling with minor depression or occasional mood swings. Forget whatever comes to mind when you hear the term aromatherapy, such as candles and bath salts. Medical aromatherapy uses REAL essential oils, not synthetic fragrance oils, to cure body, mind and soul.
Essential oils work in three ways:
1) The smell (olfactory) nerve in the nose connects directly to the deep part of the brain that controls all hormones (hypothalamus) and emotions (limbic system), instantaneously affecting everything from stress levels, to memory, to attention.
2) By inhaling the essential oils, they go through the lungs like gas anesthesia and enter the blood stream
3) Through the skin they enter the blood stream and affect cellular activity
4) By ingesting them, they enter the blood stream and effect cellular activity
EVIDENCE
For example, a number of clinical trials from around the world have shown that essential oils, and tincture extracts of plants (containing essential oils) are effective for depression when compared against standard pharmaceutical treatments (double-blind placebo control trials) with almost no side effects: lavender essential oil massage, citrus essential oils, lavender tincture, saffron tincture.
PRACTICAL SOLUTION
I find that a combination of medical quality essential oils is the most effective way to keep your mood up and treat mild depression. Internal usage of essential oils can be safe and effective when used under the guidance of a trained medical aromatherapist, or when using prediluted essential oils. In general, 1 drop of pure essential oils per day is more than enough for mild depression and can work in a short as 3-4 days. As with any medical condition, discuss it with your health care practitioner first and do not stop any current treatments abruptly. Depression lasting more than 6 weeks, or affecting your ability to work is more serious and can be treated with essential oils under the close supervision of a medical aromatherapist.
MORE INFORMATION
95% of serotonin is made in the gut, and 90% is used there for digestion, which is why many people with depression have digestive troubles--over-eating or under-eating. When serotonin levels are low in the brain, the gut sends some up to the brain in platelets to help it out. Lavender is a very good anti-depressant which also reduces stress levels and stress hormones without being sedating. It helps increase serotonin levels for the brain by reducing the use of serotonin in the gut.
Holy Basil, also known as Tulsi, is also very good and works by focusing the mind while relaxing the body. Holy basil seems to increase nor epinephrine levels.
Grapefruit gives a feeling of brightness and motivation while also increasing dopamine and nor epinephrine levels.
Clary sage is a good support for depression because it supports the adrenal gland to deal with stress and balances the nerves and hormones to bring stress levels down a notch.
Sweet Basil is also effective, but its strong after taste can be difficult to tolerate unless using a capsule. Even then, it should be diluted with olive oil and taken between meals.
CONCLUSION
No one ever hung themselves after smelling or ingesting lavender, unlike SSRI anti-depressants. For mild depression in children and adults, medical quality essential oils, inhaled, massaged or ingested can be effective with little to no side effects.
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