whmf112 session 7 - source.endeavourlearninggroup.com.au...assessment open book in-class mid...

Herbal Medicine Materia Medica 1

WHMF112

Session 7

Immune System (Immuno-modulators)

Part II

© Endeavour College of Natural Health endeavour.edu.au 1

Assessment

Open Book In-class Mid Semester Exam

Students have 1 hour (+ 5 minutes reading time) to

complete this exam.

Students may use printed notes & text books:

• Printed: powerpoint notes, herbal actions & materia

medica worksheet

Texts:

• Fisher, C. (2009). Materia Medica of Western Herbs

• Braun & Cohen, (2014). Herbs and Natural

Supplements (4th ed).

No electronic devices are allowed


Session 7

Assessment: Mid Semester Exam

Immune System (Immuno-modulators) Part II:

• Materia Medica (from Traditional literature &

research):

• Astragalus membranaceus • Hemidesmus indicus

• Eleutherococcus senticosus • Tylophora indica

• Uncaria tomentosa


Astragalus membranaceusPlant family: Leguminosae (Fabaceae)

Parts used: Root

Actions:

• immune modulation, immune enhancing

(enhanced natural killer cell activity,

increased thymus weight, balanced

Th2:Th1, enhanced T cell function,

enhanced levels of IgM, IgE, IgA and

cAMP).

• tonic, adaptogenic (saponins,

polysaccharides, flavonoids)

(van Wyk & Wink, 2004; Bone & Mills,

2013; Braun & Cohen, 2015)


(Pindari Herb Farm, 2007)

Astragalus membranaceusActions contd:

• cardiotonic, hypotensive (saponins can

modulate NA+, K

+-ATPase in heart muscle

- positive inotropic & reduced resting

potential)

• neuroprotector, nootropic

• antioxidant, hepatoprotective

(polysaccharides), hypoglycaemic,

anticarcinogenic (saponins balance

suppressed immune function caused by

tumor mediated cell signals or drugs),

diuretic

(van Wyk & Wink, 2004; Bone & Mills, 2013,

Braun & Cohen, 2015)© Endeavour College of Natural Health endeavour.edu.au 5


Astragalus membranaceus

• Enhanced DNA replication, repair and reduced

damage, cell health & longevity, protection against

cell hypoxia and enhanced tolerance to stress

including liver, kidney, heart, nerve cells.

• Nutritive high in polysaccharides, flavonoids, over 20

amino acids and trace minerals.

(Leung, 2010; Bone & Mills, 2013)



Historical & Traditional

Prescribing

• Tonifies the Qi, blood and

spleen. Liver, kidney, spleen,

lung, heart tonic

• Postpartum fever and recovery

from severe blood loss, fatigue

linked to decreased appetite,

diarrhoea and anaemia.

(Bone 2003; Braun & Cohen 2015)



Astragalus membranaceusSpecific indications:

• Common cold, chronic infections, recurring infections,

impaired immunity.

• Tonic for elderly, general debility, recuperation from illness

• Stroke recovery, congestive heart failure angina,

hypertension

• Cancer – enhances effectiveness of chemotherapy,

reduces associated side effects, supports immune system

• Chronic kidney disease



Cautions and Contraindications / Warnings;

• Not advisable to use in the acute stage of infections

Herb/Drug Interactions:

• Enhanced effect: anticoagulant, antidiabetic,

antihypertensive, antilipemic, CNS stimulant, diuretic

• Altered effects: antineoplastic, steroidal agents

• Reduced effects: beta blockers, immunosuppressant

Pregnancy and Lactation Data:

• None known

(Davis, 2011; Bone & Mills, 2013)



Preparation Adult mL/g Dosage directions &

considerations

Oral Effects are seen within two

weeks

Tincture1:2 (25%) 30-60mL/ week Reduced level of

polysaccharides. Take up to

three times per day

Dried root decoction 10-30gm/day Higher levels of

polysaccharides & saponins.

Take up to three times per

day

Energetics/Taste: Sweet and warm

(Thomsen & Gennat, 2009)

(Braun & Cohen 2015; Bone & Mills, 2013)


Eleutherococcus senticosusPlant family: Araliaceae

Parts used: Root

Actions:

• immunomodulator

• adaptogenic (modulates stress

response), tonic (anabolic activity),

endocrine tonic

• antiviral, anti-inflammatory,

hypoglycaemic, antioxidant

• hepatoprotective, neuroprotective,

cardioprotective, vasorelaxant

• Antiallergic, antiplatelet aggregating

(Bone, 2003; Braun & Cohen, 2015)



Eleutherococcus senticosus

Historical & Traditional Prescribing

• As a tonic to increase ‘Qi’ in yang

deficiency of spleen and kidney; to

increase sexual function; for

bronchitis; heart ailments;

rheumatism; to improve general

health; restore memory; promote

appetite; for longevity; as a general

tonic; considered to be sedative; to

prevent colds & flu.

(Braun & Cohen, 2015; Fisher 2018)




Specific indications:

• Increase resistance to infections; promote immune

function; herpes simplex (prevention)

• Fatigue, debility; work performance & concentration;

adrenal depletion: convalescence

• Enhance physical & mental performance

• Stress (physical, mental, emotional, environmental)

• Cancer – adjuvant therapy



Cautions / Contraindications:

• Traditional prescribing

contraindicates use in acute

infections & hypertension

Drug / Herb Interactions:

• Altered effect on digoxin

Pregnancy & Lactation:

• Category B1 in pregnancy & may be

compatible in lactation

(Leung, 2010; Bone & Mills, 2012)(Pindari Herb Farm, 2007))




considerations

Oral Healthy individuals & elderly

6 week course with 2 week

break

High doses may cause transient

insomnia, palpitations,

tachycardia and hypertension

Tincture 1:2 (25%) 15-55mL/week Take up to three times per day

Powdered or cut teas 2-3gm/day

(Blumenthal et al 2000; Hoffmann, 2003)

Energetics/Taste: Slightly sweet, warm, fibrous, woody.

(Wood, 2008; Thomsen & Gennat 2009)


Uncaria tomentosaPlant family: Rubiaceae

Parts used: Stem bark

Actions:

• Immunostimulator (oxidole alkaloids),

antifungal (topical), antiviral (topical)

• Anti-inflammatory, antioxidant

• Antitumour (TNF-α – tumor

necrosing factor alpha)

(van wyk & Wink, 2004; Mosby, 2010;

Bone, 2003; Thomsen & Gannet, 2009)(Stelfox D. (2002). Uncaria tomentosa)


Uncaria tomentosaHistorical & Traditional

Prescribing

• Used by Ashaninka priests

exclusively to eliminate

disturbance in communication

between body and spirit.

• Traditional Peruvian medicinal

uses include degenerative &

inflammatory conditions, gastric

ulcers, diabetes, asthma,

convalescence and debility.

Traditional Peruvian medicine

also used cat’s claw as a tonic or

restorative. (Bone 2003)

(Stelfox D. (2002). Uncaria tomentosa)


(Stelfox D. (2002). Uncaria tomentosa)

Uncaria tomentosa


• Poor immunity, immunodeficiency

• Debility & convalescence from illness; chronic fatigue;

AIDS, HIV infection

• Cancer; adjunctive to cancer therapy

• Arthritis – rheumatoid & osteoarthritis

• Skin infections (topical applications) – warts, fungal

infections


Uncaria tomentosa

Drug / Herb Interactions:

• Additive effects: Analgesic, anticoagulant,

antidiabetic, antihypertensive, antilipemic,

photosensitizers, inhibits CYP450 3A4 activity

• Reduced effects: oestrogens, progesterone,

immunosuppressants, nephrotoxic agents

• Altered effects: Antineoplastic, diagnostic

radiopharmaceuticals

Pregnancy and Lactation:

• Insufficient evidence. Traditional use as an

abortifacient & contraceptive (Bone, 2003; Davis,

2011)


Uncaria tomentosa


considerations

Oral Diarrhoea, nausea,

vomiting, headache after

ingestion have occurred

especially in high doses

Tincture1:2 (60%) 30-75mL/week Take up to three times per

day

Dry herb 3-6gm/day

Energetics/Taste: bitter, warm (Thomsen & Gennat

2009)

(Bone 2003; Thomsen & Gennat 2009; Davis, 2011)


Hemidesmus indicus

Plant family: Asclepiadaceae

Parts used: Root

Actions:

• Immunodepressant (on both cell-

mediated & humoral components of

immune system)

• Depurative/alterative

• Diaphoretic, anti-inflammatory

• Vulnerary (topical), antifungal

(Bone, 2003; Banerjee& Ganguly, 2014)(Ganguly B. (2013). Hemidesmus indicus Retrieved 20th

April, 2014 from

<http://upload.wikimedia.org/wikipedia/commons/thumb/5

/5d/Hemidesmus_indicus_-_Agri-

Horticultural_Society_of_India_-_Alipore_-

_Kolkata_2013-01-05_2301.JPG/320px-

Hemidesmus_indicus_-_Agri-

Horticultural_Society_of_India_-_Alipore_-

_Kolkata_2013-01-05_2301.JPG>)


Hemidesmus indicus


• In Ayurveda, it is regarded as a

depurative (similar to Smilax) and

tonic

• Diseases of the genitourinary

system

• Topically as an anti-inflammatory

remedy

• Loss of appetite, fever, skin

diseases, chronic cough

• Snake bite

(Bone 2003)Lalithamba (2010). Hemidesmus indicus var. indicus

Retrieved 20th April, 2014

from<http://upload.wikimedia.org/wikipedia/commons/thum

b/c/c3/Hemidesmus_indicus_var._indicus.jpg/320px-

Hemidesmus_indicus_var._indicus.jpg>)


http://www.flickr.com/photos/45835639@N04

Hemidesmus indicus


• Autoimmune conditions (rheumatoid arthritis, MS,

vitiligo)

• Cancer – preventive, treatment and adjunct

treatment

• Skin conditions – wounds, ulcers (especially chronic)

associated with diabetes, cancer; fungal skin

conditions

• Genitourinary infections – cystitis, urethritis, syphilis


Hemidesmus indicus

Cautions and Contraindications:

• None known


• No adverse effects are expected

Side effects / Adverse Events:

• None expected if taken within the

recommended dosage range

(Bone 2003)

(Ganguly B. (2013).Hemidesmus indicus Retrieved 20th April, 2014

from<http://upload.wikimedia.org/wikipedia/commons/thumb/a/aa/Hemidesmus_indicus_-_Agri-

Horticultural_Society_of_India_-_Alipore_-_Kolkata_2013-01-05_2303.JPG/320px-Hemidesmus_indicus_-

_Agri-Horticultural_Society_of_India_-_Alipore_-_Kolkata_2013-01-05_2303.JPG>)


Hemidesmus indicus


considerations

Oral

Tincture 1:2 (45%) 25-60mL/week Take up to three times

per day

Dried herb 3-9gm/day

(Thomsen & Gennat 2009)

Energetics/Taste: sweet, bitter, cool,

demulcent/moistening (Thomsen & Gennat 2009;

Banerjee & Ganguly, 2014)


Tylophora indica

Plant family: Asclepiadaceae

Parts used: Leaf

Actions:

• Immunodepressant, antiallergic

• Anti-inflammatory

• Antiasthmatic

• Emetic

(Bone 2003)

(Pradesh A,. (2010). Tylophora indica Retrieved 20th April, 2014

from<http://upload.wikimedia.org/wikipedia/commons/7/77/Indian_ipecac_or_Annt

mool_%28Tylophora_indica%29_in_Talakona_forest%2C_AP_W_IMG_8310.jpg>)


Tylophora indica


• Bronchial asthma, chronic

bronchitis, catarrh, dysentery,

allergies.

• Snakebite (in large doses).

• As an emetic, purgative,

diaphoretic and expectorant, a

substitute for Ipecacuanha.

(Bone 2003; Rani, et al, 2012)

(Lalithamba, (2010). Tylophora indica, Retrieved 20th

April, 2014

fromhttp://upload.wikimedia.org/wikipedia/commons/thu

mb/a/a1/Tylophora_indica_%28Burm.f%29_Merr._-

_Flickr_-_lalithamba.jpg/320px-

Tylophora_indica_%28Burm.f%29_Merr._-_Flickr_-

_lalithamba.jpg)


http://www.flickr.com/people/45835639@N04

http://upload.wikimedia.org/wikipedia/commons/thumb/a/a1/Tylophora_indica_(Burm.f)_Merr._-_Flickr_-_lalithamba.jpg/320px-Tylophora_indica_(Burm.f)_Merr._-_Flickr_-_lalithamba.jpg

Tylophora indica


• Asthma – especially allergy-related

• Allergies ( eg allergic rhinitis, dermatitis)

• Autoimmune & chronic immune-mediated

inflammatory conditions (rheumatoid arthritis, celiac

disease, lupus)


Tylophora indica

Cautions / Contraindications:

Immunocompromised patients. Do not use long term –

use short term & intermittently. Do not exceed

recommended dose range.

Warnings and Precautions:

Laxative and purgative properties

Herb/Drug Interactions:

Additive effect: CNS depressants, immunosupressants


Traditional use as an abortifacient, don’t use in

pregnancy. Not recommended in lactation

(Davis 2011; Bone, 2003)


Tylophora indicaPreparation Adult mL/g Dosage directions & considerations

Oral Short term use (max four weeks only)

Side effects abdominal pain, diarrhoea,

dysgeusia, mouth soreness,

nausea/vomiting, ↑ salivation even at

low dose

Tincture 1:5

(45%)

7-14mL/ week Take up to three times per day

First 10 to 14 days of each calendar

month (20-50 drops/day) – start with 5

drops per dose

Dry herb 200-400mg / day 1-3 times per day

Energetics/Taste: cool (Thomsen & Gennat 2009)

(Bone 2003, Thomsen & Gennat 2009; Davis, 2011)


Discussion

Class Discussion:

• When would you use immuno-suppressant herbs?

• What dosage (within a weekly range) would you

employ & why?

• How long would you use them for?

• When would you stop? Why?


References(2010). Astragalus. In Leung's encyclopedia of common natural ingredients:

Used in food, drugs and cosmetics, Wiley, Hoboken, USA. Retrieved 11

July 2014, from Credo Reference

(2010) Eleuthero. In Leung's encyclopedia of common natural ingredients:

Used in food, drugs and cosmetics, Wiley, Hoboken, USA. Retrieved 11

July 2014, from Credo Reference

(2010). Cat's claw. In Mosby's handbook of herbs & natural supplements,

Elsevier Health Sciences, Philadelphia, USA. Retrieved 11 July 2014, from

Credo Reference

(2011). Astragalus (Astragalus membranaceus). In Davis's pocket guide to

herbs and supplements, F.A.Davis Company, Philadelphia, USA.

Accessed: 11 July 2014, from Credo Reference

(2011). Cat's claw (Uncaria tomentosa, Uncaria guianensis. In Davis's pocket

guide to herbs and supplements, F.A.Davis Company, Philadelphia, USA.

Accessed: 11 July 2014, from Credo Reference

(2012) Review of Tylophora indica –an antiasthmatic plant. J. Res Basic and

App Sci. Vol1 (3)

(2014). Medicinal importance of Hemidesmus inducus: a review on its utilities

from ancient Ayurveda to 20th century. Advances in Bioresearch, Vol 5 (3);

208-213

References

Bone, K. (2003). A clinical guide to blending liquid herbs: Herbal

formulations for the individual patient. St. Louis, Missouri. Churchill

Livingston.

Bone, K., & Mills, S. (2013). Principles and practice of phytotherapy (2nd

ed.). New York, USA. Churchill Livingston Elsevier.

Braun, L., & Cohen, M. (2010). Herbs and natural supplements: An

evidence based approach, vol. 2 (4th ed.). Chatswood, NSW. Churchill

Livingstone Elsevier.

Ellingwood, F. (1898). American materia medica, therapeutics and

pharmacognosy. Reprint, Eclectic medical publications

Fisher, C. (2009). Materia medica of western herbs. Nelson, New

Zealand. Vitex Medic.

Hoffmann, D. (2003). Medical herbalism: The science and practice of

herbal medicine, Rochester, Vermont. Healing Arts Press.

References

Thomsen, M., & Gennat, H. (2009). Phytotherapy desk reference. Global

Natural Medicine Pty Ltd l. Retrieved 20th February, 2015 from

www.globalnaturalmedicine.com

Van Wyk, B., & Wink, B. (2010). Medicinal plants of the world. London,

UK. Timber Press Inc.

Wood, M. (2008). The Earthwise herbal: A complete guide to old world

medicinal plants. Berkley, California. North Atlantic Books.

http://www.globalnaturalmedicine.com/

Recommended Readings

Braun, L., & Cohen, M. (2015). Herbs and natural supplements: An

evidence based approach, vol. 2 (4th ed.). Chatswood, NSW.

Churchill Livingstone Elsevier.

• Astragalus membranaceus p. 41-47

• Eleutherococcus senticosus p. 458-465

Fisher, C. (2009). Materia medica of western herbs. Nelson, New

Zealand. Vitex Medic.

• Baptisia tinctoria p. 100-101

• Eleutherococcus senticosus p. 15-17

Monograph on Astragalus by Alternative Medicine Review 2003

Thorne Research Vol 8 No 1

http://www.altmedrev.com/publications/8/1/72.pdf

http://www.altmedrev.com/publications/8/1/72.pdf


You, Y. et al. (2012). Antiatherosclerotic function of Astragali

Radix extract: Downregulation of adhesion molecules in vitro

and in vivo. BMC Complementary & Alternative Medicine

12:54 http://www.biomedcentral.com/1472-6882/12/54

World Health Organisation. (2007). WHO monographs on selected

medicinal plants Volume 3. 2007, Geneva Switzerland: World

Health Organisation.

• Monograph on Uncaria

http://apps.who.int/medicinedocs/en/m/abstract/Js16713e/

http://www.biomedcentral.com/1472-6882/12/54

http://apps.who.int/medicinedocs/en/m/abstract/Js16713e/


World Health Organisation (1999). WHO monographs on selected

medicinal plants Volume 1. Geneva Switzerland: World Health

Organisation.

• Monograph on Astragalus

http://apps.who.int/medicinedocs/en/d/Js2200e/7.html

World Health Organisation. (2004). WHO monographs on selected

medicinal plants Vol. 2. Geneva Switzerland: World Health

Organisation.

• Monograph on Eleutherococcus




whmf112 session 7 - source.endeavourlearninggroup.com.au...assessment open book in-class mid...

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