All Women’s Wisdom Workshops are $100 a day, advanced registration is required. To read full class descriptions, teacher bios, and sign up click on the link to their individual pages.

Ayurvedic Constitutional Medicine with Western Herbs

Taught by Candis Cantin Kiriajes, Saturday February 11

Wild Cultivation of Chinese Herbs

Taught by Peg Schafer, Sunday March 11

Aroma Herbalism

Taught by Kathi Keville, Sunday April 15

Herbal Therapeutic Treatments for the Thyroid

Taught by Christa Sinadinos, Saturday and Sunday August 18-19

Plant Energetics

Taught by Karyn Sanders, Saturday and Sunday September 8-9

Wild Edibles

Taught by Autumn Summers, Sunday October 7]]> http://www.ohlonecenter.org/blog/2012-womens-wisdom-workshop-series/feed/ 0 http://www.ohlonecenter.org/blog/free-herb-walk-in-san-francisco/ http://www.ohlonecenter.org/blog/free-herb-walk-in-san-francisco/#comments Wed, 14 Sep 2011 22:20:33 +0000 ohlone http://www.ohlonecenter.org/?p=1038 The incredible Alemany Farm (alemanyfarm.org) is hosting an urban herb walk by Katie Delwiche, a former student at Ohlone, this coming Sunday morning Sept. 18th, 2011 from 10:00-11:30, with a potluck to follow.  Learn remedies to stay healthy through autumn and winter.  This is a free and kid-friendly event.  More info on Katie’s blog:
http://wiseleaf.wordpress.com/2011/09/07/herb-walk-at-alemany-farm-sept-18th/

Friday, October 7th from 3 to 9pm.

You can RSVP and share this event on facebook!:  https://www.facebook.com/ohlonecenter#!/event.php?eid=282476755111466

By Pam Fischer, August 2nd, 2011

Many herb schools are located in the sacred temple of the woods.  In these places there is more immediate access to the mindfulness of the plant spirits.  There the pace of life slows and we are reminded by the breeze and the buzzing of bees about the present moment.  In these temples we find   teachers who have created these sanctuaries from the very depth of their hearts.  They magnify their love for plants and animals creating a haven in which to learn.  The human spirit loves to dance and frolic in these beautiful places.

The urban school has a different flavor, often a bit more edgy and geared toward how to serve.  In these spaces we attempt to carry the plant energies from wild areas back to the place of the greatest suffering and pain. In these centers we teach not just about the herbs but how to hold, protect and feed ourselves.It is a warriors path, and not right for all.   The vibration quality of the city is much more maniac, constant distractions of noise, lights, and sensory stimulation creates a far different experience.  The urban herbalist must carry the wild within them.  The city atmosphere requires us to perceive and respond to things quickly with both compassion and urgency all while staying grounded and centered.  No easy task in the midst of so many distractions. Urban schools are also a creation from the hearts of the teachers and the manifestation of their work in the world.  The urban herbalist is edgy and forthright…a reflection of the world in which they walk.

Mother Theresa work to relieve pain and suffering called her to the most impoverished areas of India, many carry on her work as nameless army doing amazing things to transform the state of the world.  The urban herbalist are doing no less in the trenches of the inner city.

We are a hand in timesof cultural mental illness that provide type of sanity and direction to healing.  It is not our task to care for (creating dependence) rather to enable all to care for themselves physically, mentally and spiritually (creating independence).  We are herbalist, but also counselors, social workers, botanists, chemists and visionaries.   We often feel inadequate to the task at hand, but are called forth to spite this feeling to that of the world needs.

You can read more about Huckleberry Preserve here: http://www.ebparks.org/parks/huckleberry

To register use the contact form to the right or call us at (510) 540-8010.

Genetic Roadblock

Kerry Hughes

June 2011

Pregnancy Overview

Pregnancy is the carrying of one or more offspring, with normal gestation being 37-42 weeks after the last normal menstrual period, or 40 weeks in a woman who normally has a cycle length of 4 weeks.   The duration of pregnancy is usually termed in “Trimesters”, with the first trimester occurring until the end of week 12, the second trimester ending at the week 29, and the third trimester occurring until childbirth, or around 40 weeks.

During the first trimester, most women feel the worse, as nausea and other symptoms may be more prevalent for them during this time. This is because the pregnancy hormones, which begin to soar right away in pregnancy, are mostly manufactured by the woman’s pituitary gland.  Around week 10, the placenta largely  begins to takes over the manufacture of these pregnancy hormones and the pregnant woman often begins feeling much better at this point.  During the first trimester is when the risk of miscarriage is the highest as well, and the chances of miscarriage begin to drastically drop off around week 10.

Also, during the last trimester of pregnancy there are a number of other symptoms/discomforts that are common, as the body gets heavier and circulation is more difficult in the body. One of these discomforts is the swelling of the feet and ankles due to more taxed circulation.

Pregnancy complaints/symptoms usually vary by the time in pregnancy, so too, herbal care during pregnancy should take account to when during pregnancy the discomfort is experienced and why.  Below is an overview of some of the most common complaints or symptoms of pregnancy for which herbal care may be appropriate.

Table 1. Pregnancy Progression

Source: Wikipedia: http://en.wikipedia.org/wiki/File:Prenatal_development_table.svg

Basic Herbal Approach

Herbs should be employed carefully and consciously during pregnancy to make sure the benefit outweighs the risk, just as the use of any pharmaceutical or medical intervention in relation to a non-pregnant person. In this respect, it is best to avoid the use of herbs as therapeutic agents (or other medications) during pregnancy unless needed, especially during the first trimester.   However, there are several “herbs” that are safe enough to be considered foods, and others that have a well-established (through use by midwives and pregnant women) nutritive function during pregnancy, and these can be used safely.

A Note about Herbal Research in Pregnancy

One of the most misleading aspects of choosing herbal care during pregnancy is the fact that most herbal reference texts and herbal products commonly skirt the issue of safety during pregnancy by simply stating a person should ‘consult their healthcare professional before using during pregnancy’ or they say that due to a ‘lack of research’ on a particular herb, that it is not recommended for pregnancy.  This is misleading, and rather annoying, as it does not give the mother-to-be any information about why it may not be recommended, it is simply passing the responsibility on to either the healthcare professional or disregarding what could be a useful and safe alternative for herbal care during pregnancy because they have not done their homework and have no basis on which to form an opinion or educate.

That being said, there is very little research on the use of most herbs in pregnancy, and so it is important for a woman or doctor to decide if they will not use herbs just because of the lack of safety studies in pregnancy—some practitioners and women will take this viewpoint, and it is a ‘conservative’ approach, as it goes along with western medical thought. However, it may not be ‘conservative’ when viewed at what might be the alternatives that are taken by women for relief of common pregnancy discomforts.  The next place people look for information on the use of herbs during pregnancy is from herbal tradition and midwives. There are a number of herbs that are commonly used during pregnancy, such as raspberry leaf tea and nettles that have very little research associated with them, but a long tradition of use by pregnant women themselves.  Therefore, it is important for a woman to make up her own mind about how much assurance they want before using an herb.

Herbal Nutrition

Herbs have a nutritive function in pregnancy beyond their use in soothing common discomforts. Women have many needs from their nutrition when they are growing a baby, and it is well-accepted that women should take a prenatal vitamin and mineral supplement before and during pregnancy. Also very important for women is to supplement with omega-3 fatty acids, such as DHA, as there is plenty of research that links DHA with better outcomes for both baby and mother.  There are herbal sources of omega-3 fatty acids, such as flax seeds that are safe to consume during pregnancy, and may be ground up and included in food.

Herbs for Iron

Iron during pregnancy is important because approximately 20% of women become deficient while pregnant. During pregnancy the body produces about 50% more blood than usual, so it is easy to understand why iron demands are so high.

Despite what many think, herbs and vegetables can be good sources of iron, it is not necessary to be eating large amounts of meat to obtain iron.  Good sources for iron during pregnancy include raspberry leaf tea, nettle leaf tea, peppermint, dandelion, fennel, ginger, prunes, rosehip, and blackstrap molasses. A wonderful brand-name product that has been on the market for a long time and used by pregnant women is Floradix -Iron + Herbs. In order to increase absorption of iron, it is also important to consume enough vitamin C.

A nice herbal iron formula would be to combine the following herbs and make a nutritive vinegar with equal parts: yellow dock, nettles, dandelion root + leaf, and apricots (unsulfured).

Herbs for Vitamin C

Vitamin C is important for several essential functions for you and your baby, including tissue repair, wound healing, bone growth and repair, healthy skin,  and helping the body to fight infection. There are several good herbal sources of vitamin C, including rose hips, camu camu, acerola, alfalfa, peppermint, horsetail and raspberry leaf.  It is easy to obtain the vitamin C you need in foods and herbs, so it is not necessary to supplement separately with it.

Red Raspberry Leaf

Some call red raspberry leaf tea the supreme herb for pregnancy. It is thought to strengthen the uterine wall, relax smooth muscle, and help to make delivery easier and speedier by helping the uterus contract more efficiently.  Red raspberry leaf tea also contains a number of nutrients that are helpful for pregnancy, including calcium, iron and B vitamins.

Some medical professionals make reference to a possibility of red raspberry leaf bringing on miscarriage. This is due to a study back in the 1950’s where fractions of the raspberry leaf were isolated and tested in vitro to the uterine tissues of guinea pigs and frogs.  Spasmolytic and uterine contractions were caused by separate fractions. However, this is common for studies on purified fractions of herbs to find contraindications that may not be a problem in the whole plant. A newer study (from 2010) found that the ability of red raspberry leaf preparations to augment uterine contraction was variable and dependant on the type of herbal preparation used, and they concluded that their results do not support the hypothesis that red raspberry leaf augments labor by a direct effect on uterine contractility.  Some women prone to miscarriage and due to this research (the first more cited study) choose not to consume red raspberry leaf until later in the pregnancy or after the first trimester. [1] [2]

Nettle Leaf  Tea

Nettle contains vitamins A, K and C, as well as calcium, iron and potassium. It is best used in dried form and made into a nutritive tea for use during pregnancy. Nettle is another one of the herbs for which there is confusion or misinformation passed around about whether or not it might have a uterine contracting effect during pregnancy, so many doctors will not recommend it do this. However, it should be clarified that it seems to be the dried nettle that is used in pregnancy for its nutritive effect, not the fresh plant, as the fresh plant may have concerns on stimulating uterine contractions (but yet this is also not certain). The American Pregnancy Association explains that many herbalists and midwives use and recommend stinging nettle tea for its vitamins and minerals, yet the Natural Medicines Database gives it a rating as possibly unsafe.

Common Discomforts/Conditions of Pregnancy & Herbs

Nausea/vomiting

Nausea is the most common (experienced by up to 90% of women) during the first trimester as the pregnant woman’s body is getting used to the hormones produced in the body, and while the pituitary gland is producing the hormones. It is thought that nausea is more commonly experienced by some women especially while they are low in blood sugar, or after a period of fasting, such as in the morning (after sleeping all night and not eating).   Therefore, one of the common suggestions for nausea is for women to eat something, especially something that will not upset their stomach, first thing in the morning (like a saltine cracker), perhaps before even getting out of bed.

One of the most famous herbs for nausea in general is ginger. This is one of the herbs that is safe and could be classified as food, as well, and can be useful during pregnancy. Another wonderful thing about ginger is that it comes in so many useful forms. It may be used as a warming herbal tea (just decocting ginger in water), it may be eaten as a food (eg. Candied ginger is great for this), and it may also be used in essential oil form.  When using as an essential oil, a woman may only need to sniff the ginger scent to help her to hold back her nausea. In some stores, ginger is available in an herbal nasal inhaler form, which can be a very portable and safe way for a woman to have it ready for use at any time. [3] If ginger seems not to do the trick, peppermint or peachleaf tea can be tried.

Ankle/Hand Swelling

Swelling in the extremities—especially in the feet and ankles—is a very common symptom of pregnancy, which usually is experienced and gets worse during the third trimester.  Minor swelling during pregnancy is considered normal. Most of the first actions to take while combating prenatal swelling are physical: avoid standing for long periods of time; avoid going out during hot climate conditions; don’t wear too tight pants or socks (esp. socks with bands), as these inhibit circulation; change positions while sleeping frequently; go out and get some exercise, as circulation is improved with exercise.  If the hands or face swell, or if swelling is more on one side of the body than the other, it is recommended to notify the health care professional, as it could be a sign of preeclampsia or another condition.

A couple Ayurvedic recipes involve the use of safe kitchen spices: 1- a few tablespoons of coriander in two cups water (boiled to one cup, and taken throughout the day, if desired with sugar and milk); 2- tea of fennel and palm sugar (2 cups water, 1 tsp palm sugar, 2 tsp fennel seeds; boiled until one cup remains) taken throughout the day.

Although there is not much research on the use of Poria mushroom for use in pregnancy, it is a common herb used in Traditional Chinese Medicine (TCM) for reducing edema, and is often used in pregnancy.

Other suggestions involve eating bitters, such as dandelion greens, which help the body metabolize fluids, eating extra garlic and onions, as it is known to promote good circulation, and eating foods that are natural gentle diuretics, such as celery, artichokes, parsley, and grapes.

Heartburn

Heartburn is another common discomfort during late pregnancy, as the internal organs, including the stomach, have less space due to the large developing fetus, and because the pregnancy hormones slow down digestion.  It can be experienced earlier in pregnancy, but as the hormone levels rise and pressure on the stomach increases, usually so does the incidence of heartburn.  Heartburn is just another term for indigestion, usually experienced as a burning sensation that starts in stomach and rises to the throat.

Common sense treatments include eating smaller meals throughout the day instead of three large meals; eating slowly, not lying down directly after eating; avoiding eating fried, spicy or rich foods, and avoiding mixing fatty and sweet foods together during meals.   Conventional treatments include antacid heartburn relievers, such as Tums, Maalox, Titralac, Mylanta, Riopan, and Gaviscon.

A tea of chamomile or peppermint is useful in decreasing acid and soothing the digestive system, and is commonly thought to be safe during pregnancy.   Prune juice (a small cup morning and night) is a safe and effective way to get the digestive system functioning, and can help heartburn if intestinal motility is a factor in the mother-to-be’s heartburn symptoms. Other dietary approaches for heartburn include eating carrots, apples, and lemon juice, which contain vegetable acids that can help to neutralize stomach acid.

Sensitive Teeth + bleeding gums

Another common symptom during pregnancy is sensitive teeth and the bleeding of the gums.  It is important that if there is excessive gum bleeding that the mother-to-be visits the dentist or doctor about this problem, as it could affect the health of the baby and delivery.  However, it is normal that as circulation and the supply of certain hormones increase in the body that there may be tenderness, swelling and bleeding of the gums.

The use of a soft toothbrush and toothpaste for sensitive teeth are often first measures to take with sensitive teeth.   It is also good to eat foods high in vitamin C, such as lemons, oranges, limes, kiwis, and mangos. Camu camu is a ‘super fruit’ from the Amazonian regions that is one of the highest sources of vitamin C.  Camu camu can be taken in supplement form, or as a food, such as a beverage.

Fatigue/Anemia

Fatigue is another common symptom of pregnancy that often hits women starting in the first trimester, and can endure throughout the pregnancy.   A certain amount of fatigue is normal and to be expected during pregnancy, as growing a baby takes extra energy and may make the mother-to-be feel tired!  As getting enough rest and sleep is important at any time for our health, it becomes mandatory for a good pregnancy and to care for the growing baby.  Regular exercise is also important during pregnancy, as it can help reduce the risk of developing discomforts and problems during the pregnancy.

When fatigue becomes severe, it is important to visit a doctor to find out if anemia is present.  Normally, prenatal care includes a normal program of testing the blood for presence of anemia (low iron in the blood). If anemia is not present in the beginning of the pregnancy, this does not mean that it will not become a problem later, and normally if it does show up during the pregnancy it usually happens by around the end of the second trimester.   If anemia is present, or simply to prevent fatigue, it is possible to increase the intake of foods and herbs that are high in iron (see nutritive recommendations above).

Difficulty Sleeping/ Insomnia

Finding a comfortable sleeping position may become difficult in later pregnancy.  It is generally not recommended that women lie on their backs during mid-late pregnancy, as this can result in decreased circulation to the mother and baby.  Sleeping on the left side of the body, supported by pillows,  is thought to be the optimal sleeping position.

It is not recommended for mothers-to-be to take sleep medication.  A little warm milk may be all that is needed before bedtime to help induce sleepiness. Teas of chamomile, lemon balm, oat straw and marjoram may have a relaxing effect on the mother, and are safe during pregnancy.   Essential oils may also aid in relaxation and sleep, such as lavender placed on an herbal pillow.

Constipation

Hormones as well as taking certain vitamin supplements, such as iron, may cause constipation.  Pressure on the rectum by the uterus may also cause constipation.  Another factor is that some women who are regular consumers of coffee or caffeine-containing beverages may find that they have become somewhat dependent on their caffeine-consuming rituals for regular bowel function, and may result in constipation if this ‘ritual’ is stopped or altered, as most feel it is important to cut back on caffeine consumption during pregnancy.

Doctors generally now are saying a low level of caffeine intake during pregnancy is ok (like one cup daily), so if a disruption of caffeine consumption is causing constipation, then perhaps continuing with decaf coffee or a small amount in the morning could be enough to get the bowels moving. Preferably, it is best to decrease or eliminate caffeine and to adopt other strategies for helping digestive motility, such as: adding more fiber to the diet, drinking plenty of fluids, and drinking warm liquids in the morning, exercising daily.  A safe natural laxative is a small cup of prune juice in the morning and evening, and this could be enough to make the system regular.   Psyllium fiber is also thought to be safe during pregnancy.

Hemorrhoids

Hemorrhoids are swollen veins that are like painful lumps on the anus. They are a frequent symptom of pregnancy due to increased circulation and pressure on the rectum and vagina due to the growing baby.  One of the fist things that should be avoided when hemorrhoids are a concern is constipation, as constipation can cause hemorrhoids and also make them more painful.  Other things to avoid is sitting or standing for long periods of time, straining during bowel movements.  Ice packs can be used on the area to help with the pain, or a warm bath may also provide relieve. It is also recommended to avoid wearing tight-fitting underwear, pants or pantyhose.

Herbal treatments like above may help with relieving constipation and therefore hemorrhoids.  Longer term use of other herbs, such as those high in bioflavonoids (like bilberry) and other antioxidants, can help increase general vein health and therefore prevent conditions such as hemorrhoids and varicose veins.  For relief of the pain and swelling of hemorrhoids during pregnancy, aloe gel applied topically can sooth the sore rectum, as well as the use of homeopathic calendula ointment, or a calendula salve.

Leg Cramps

Leg cramps during pregnancy are another common complaint and can occur due to both the increasing pressure of the growing uterus, as well as imbalances or deficiencies of certain minerals like calcium and potassium.

There are some physical measures that can be taken to reduce the potential for leg cramps: wear comfortable shoes, elevate the legs when possible, exercise daily, stretch the legs before going to bed, avoid lying on the back, massage on the legs and feet, foot and leg warm baths or hot water bottles. Secondly, it is important to consume foods rich in calcium, such as milk, broccoli or cheese.

Red raspberry leaf is a long-used herb in pregnancy as a nutritive and tonic for the female system.  It also is a good source of calcium—even when consumed as a tea.  A tea made of any of the following herbs is reported to contain 250-300 mg of calcium per cup (1 ounce of dried herbs steep in 1 quart of water for 4 hours): Raspberry leaf (Rubus idaeus), nettle (Urtica dioica), oatstraw (Avena sativa) and chickweed (Stellaria media).

Stretch Marks

Pregnancy definitely makes the skin of the body stretch to proportions that it is not normally used to, and the result for some women is stretch marks. They are a type of scar tissue that forms when the skin’s normal elasticity is not enough for the stretching that is required of the skin—they can normally appear on the abdomen, breasts, buttocks or thighs, and although they normally will not disappear completely, they will fade after delivery.  According the conventional theories, they occur to the surface under the skin and so they are usually not preventable. However, there are a number of herbs and oils that can help to deeply moisturize the skin, such as aloe vera gel, shea butter, and cocoa butter. Additionally, including in the diet vitamins and minerals that nourish the skin can be important, such as vitamin A, vitamin C and vitamin E.  Herbs such as nettle and horsetail are known to be nutritive to the skin and can be taken in tea form or supplements.

Stretch marks are a type of scar tissue that forms when the skin’s normal elasticity is not enough for the stretching required during pregnancy. They usually appear on the abdomen and can also appear on the breasts, buttocks or thighs. While they won’t disappear completely, stretch marks will fade after delivery. Stretch marks affect the surface under the skin and are usually not preventable.

Delivery

Just as there are 3 phases of pregnancy—the three trimesters—and there are also 3 stages of labor: the first stage is when the cervix is ripening, the second stage is from full dilation through the pushing and delivery of the baby, and the third stage of labor is the delivery of the placenta.

Leading up to the delivery, a formula can be taken to help ready the woman’s body for a smooth childbirth. This formula is called a “parchuriant formula” and the below example should be taken in the amount of ½ tsp, 3 times a day starting at about 36 weeks of pregnancy.

3 parts- Michella (Partridge berry)

2 parts- Viburnum prunifolium

1 part- Cimicifuga

In early labor a formula may be taken to help tonify the women’s uterus and act as nerviness as well: 1 part raspberry leaf, 1 part Mitchella, 2 parts chamomile,  and 3 parts passionflower.

After the delivery of the baby to help expel the placenta, goldenseal may be taken, or some midwives recommend a simple glass of red wine.   After the delivery a soothing and astringent herbal sitz bath with rose petals can help the mother to heal.

Another formula may be taken after the birth to help normalize the hormones, protect against postpartum depression, stabilize the pituitary gland and ease transitions, which is 1 part Vitex, 1 part Melissa, 2 parts Crataegus, and ¼ part fennel.

Concluding thoughts

Herbal care during pregnancy is a broad topic, yet there are many simple and gentle herbal approaches that can ease the common discomforts of pregnancy and help nourish the body and growing baby.

[1] Holst L, Haavik S, Nordeng H. Raspberry leaf–should it be recommended to pregnant women? Complement Ther Clin Pract. 2009 Nov;15(4):204-8. Epub 2009 Jun 13. Review.

[2] Jing Zheng, Pistilli MJ, Holloway AC, Crankshaw DJ. The effects of commercial preparations of red raspberry leaf on the contractility of the rat’s uterus in vitro. Reprod Sci. 2010 May;17(5):494-501. Epub 2010 Mar 10.

[3] Ebrahimi N, Maltepe C, Einarson A.Optimal management of nausea and vomiting of pregnancy. Int J Womens Health. 2010 Aug 4;2:241-8.

Herbal Therapeutics Paper 2011

Cole Lea

Introduction

There are increasing rates of asthma in America. More and more people are looking to holistic treatments to help minimize asthma symptoms and to mitigate the unwanted effects of pharmaceuticals prescribed for the condition. Herbs, nutritional support, lifestyle changes and flower essences can help treat, control and even reverse asthma symptoms. These therapies are most effective when used as preventative tonics and for symptom control in the early stages of asthma attacks. Herbal therapy does not replace allopathic support, like rescue inhalers, for severe asthma attacks.

Are asthmatics canaries in the coal-mine? I wondered this after being diagnosed with asthma myself in my teenage years and reading about and noticing the higher than normal rates of asthma in the area I was raised. A common way that doctors and medical texts describe asthma is to say people have bronchial passages that are more sensitive than normal to allergens, irritation, and pollution. Perhaps more and more people are developing asthma because there is more and more pollution and chemicals in our environment.

According to the Centers for Disease control and Prevention (CDC) 24.6 million Americans are diagnosed with asthma. That is roughly 8 percent. Between 2001 and 2009 there has been a 12 percent hike in asthma in America. This increase hit black children especially hard with an almost 50 percent hike in that eight year period and as of 2009 a full 17 percent of black children suffered from asthma, the largest amount of any group.

Asthma is often well controlled by allopathic medications. Unfortunately the per-person cost for treating asthma averages about $3,300 per year and many people are forced to go with out care because of economic reasons.

Insurance coverage also has a huge impact: 2 in every 5 uninsured people with asthma are unable to afford medication to treat their condition, compared to 1 in every 9 people with insurance. Lack of insurance and access to asthma medications is a huge factor in asthma hospitalizations and deaths. Since 1980 the death rate for asthma has increased 50 percent with the childhood death rate increasing 80 percent!

Every day in America:

• 40,000 people miss school or work due to asthma.
• 30,000 people have an asthma attack.
• 5,000 people visit the emergency room due to asthma.
• 1,000 people are admitted to the hospital due to asthma.
• 11 people die from asthma.

Mortality Rates:

• There are more than 4,000 deaths due to asthma each year, many of which are avoidable with proper treatment and care. In addition, asthma is indicated as “contributing factor” for nearly 7,000 other deaths each year.
• More females die of asthma than males, and women account for nearly 65% of asthma deaths overall.
• African Americans are three times more likely to die from asthma.
• African American Women have the highest asthma mortality rate of all groups, more than 2.5 times higher than Caucasian women.

Asthma Triggers and Symptoms

Many people with asthma can reduce the occurrence of asthma symptoms by avoiding triggers. Unfortunately there are sometimes triggers that are more difficult to avoid which is one reason children with asthma, people living in polluted areas, and people who do work with chemicals are more likely to have fatal asthma attacks.

Asthma is a chronic inflammatory condition. It is a lung disorder in which the airways are more sensitive than typical, and can become seriously inflamed making breathing very difficult. There is often inflammation in the bronchial tubes, constriction of muscles surrounding the bronchial tubes, and the production of mucus or sputum. The sensitivity of the airways leads to inflammation deep in the lungs. In response to the inflammation there is a production of mucus and a tightening of the muscles surrounding the bronchial tubes. All of these things together cause narrower tighter airways and the symptoms of asthma.

Asthma is characterized by the following symptoms:

• Wheezing on expiration, a tickle in the airway
• Tightness of chest, sometimes painful
• Coughing, usually dry coughing
• Production of mucous clogging the airway
• Shortness of breath, often described as not being able to get a deep enough breath or a feeling of breathing through a straw
• Broncho-constriction and swelling of the bronchial tubes

Asthma Triggers

There are many, many different triggers for asthma attacks. An asthma attack can be described as the symptoms of asthma responding to a trigger. Many asthma triggers are very different for different people. For example weather changes can cause an extreme flare up of asthma symptoms in one person with asthma and have absolutely no effect on someone else.

Since it is so different for everyone one of the most important things in helping someone with asthma can be figuring out what triggers they have and in what ways asthma symptoms manifest for them. Another thing that can be particularly helpful aside from avoiding triggers is identifying and listening to warning signs. Often times there is a tickle in your throat or a slight tightness in the chest that, if caught early and treated, can be prevented from developing into a full blown asthma attack. Some of the treatments, allopathic or herbal, will not work for everyone with asthma. Some treatments will work depending on the symptom or the trigger. All of these things are important to keep in mind when developing a treatment plan.

Allergies are one of the main triggers for asthma. In childhood asthma it is estimated 75% is related to allergies. Below are some seemingly unrelated symptoms people have that can be a signal of allergic asthma.

Allergic symptoms that can indicate allergic symptoms:

Migraines

Hay fever

Eczema

Hives

Other triggers of asthma symptoms:

• Ingested allergens such as food, drugs, food additives, yeasts or molds. Some common food triggers are dairy, eggs, soy, wheat, red wine, dried fruit, shellfish, and food additive monosodium glutamate (msg).
• Airborne pollutants like dust, wood smoke, mold, chemicals, perfume.
• Heartburn. As much as 30 percent of all asthma may be caused by gastric reflux.
• Exercise and Weather Changes. Cold and dry is more irritating to asthma than warm and moist.
• Emotional or Physical Stress.
• Colds and Respiratory Infections.

Once a person is exposed to one of their triggers, the airways can become more and more sensitive to other triggers. They can even become sensitive to things that didn’t bother them before.

Allopathic Treatment of Asthma

The two most common types of pharmaceuticals prescribed for asthma are steroidal anti-inflammatory drugs and bronchodilators. Bronchodilators are drugs used for short-term emergency situations and anti-inflammatory drugs are prescribed for both short and long-term management of symptoms and to prevent asthma attacks in the future. Not every person that has asthma takes a long-term anti-inflammatory drug but if they are using their inhaler more often than their doctor likes they will be prescribed one.

Bronchodilators are usually what you think of when you imagine an asthma inhaler. They are also called rescue inhalers and they relieve the symptoms of asthma by relaxing the muscles that tighten around the airways. This will let more and more air come in the lungs and helps clear mucus from the lungs by opening the airways. Bronchodilators are what people use when they are having an asthma attack. Common types of bronchodilators are Proventil (albuterol) and Xopenex (levabuterol).

Anti-inflammatory drugs are given in serious acute situations orally. Oral corticosteroids like Deltasone and Metacorten (prednisone) are prescribed for 2 or 3 day periods. Inhaled anti-inflammatory corticosteroids drugs are prescribed to take daily and sometimes they are packaged in a typical inhaler like Flovent (fluticasone), sometimes they are packaged in a diskus with inhaled powder like Advair (fluticasone and salmeterol). These inhaled corticosteroids prevent asthma attacks from happening in the first place by reducing inflammation and sensitivity in the airways on an ongoing basis. They cannot be used in asthma attacks and they are not rescue inhalers. Finally many people who have allergy related asthma are prescribed allergy medication in addition to their long-term corticosteroid. Long-term asthma symptom prevention and allergy control are two areas where holistic treatments really shine!

Common Unwanted Effects of Pharmaceuticals

Proventil, Accuneb (Albuterol)

• nervousness
• dizziness
• headache
• nausea
• sinus inflammation
• sore or dry throat
• tremor
• trouble sleeping
• vomiting.
• sinus inflammation
• unusual taste in mouth

Xopenex (levabuterol)

• dizziness
• tremor or nervousness
• anxiety
• headache
• cough or runny nose
• upset stomach
• leg cramps

Deltasone or Metacorten (prednisone)

• difficulty sleeping
• nervousness
• feeling of a whirling motion
• increased appetite
• increased sweating
• indigestion
• mood changes

Flovent (fluticasone)

• dry mouth
• flu
• headache
• hoarseness
• nasal discharge
• runny nose
• sinus swelling
• sore throat
• stuffy nose
• upper respiratory tract infection.

Advair (fluticasone and salmetrol)

• upper respiratory tract infections
• headaches
• sore throat
• bronchitis
• coughing
• nausea and vomiting
• sinus infections
• hoarseness or voice changes
• muscle pain or bone pain
• fever
• menstrual problems
• thrush
• abdominal pain
• diarrhea
• dizziness
• bloody nose

Many of the drugs prescribed for asthma are steroids or corticosteroids and they have similar unwanted effects like nervousness, anxiety, insomnia, and respiratory infections. These unwanted effects are often minimized with the use of calming nervines and long term use of adaptogens. It is a good idea to make sure the person you are working with is not allergic to plants in the Asteraceae family as these plants could potentially trigger asthma symptoms.

Holistic Treatments for Asthma

Lifestyle changes for people dealing with asthma symptoms are the obvious first step and they can often cause dramatic improvement. Once asthma triggers have been identified they can be eliminated as much as possible. Pet dander, cigarette smoke, dust, mold, and food allergies; all of these things can be controlled and avoided to a certain extent. If someone is unsure about what is causing the allergy an elimination diet can be used. In an elimination diet a person stops eating sugar, dairy, gluten, eggs, soy, food and beverages with sulphates, alcohol, chocolate, and then reintroduces the foods one at a time being careful to notice any sensitivity or asthma symptoms. This can also be used for products like soap, cleansers, and laundry detergent. People are commonly very reactive to the dyes and fragrances used in commercial cleaning products and personal care products, so eliminating their use for several weeks and only using water diluted castille soap is similar to the elimination diet. Then you watch for reactions when reintroducing the products. Many with asthma symptoms are so sensitive to chemical fragrances they will choose to make their own cleaning and personal care products and this is a great idea!

Stress reduction is another important factor that can make a huge difference. The benefits of herbal adaptogens and nervines are invaluable here. I like to think of adaptogens with an affinity for the respiratory system like Reishi (Ganoderma lucidum), or Holy Basil/Tulsi (Ocimum tenuiflorum) .

If there are triggers we cannot exactly eliminate completely like pollution, weather or seasonal allergies, we can herbally support the client in a way tailored to that trigger. For example Stinging Nettle (Urtica doica) is an excellent treatment for allergy related asthma. Folks who have indoor allergies sometimes are able to minimize symptoms by purchasing and air filter. I have found it helpful to wear a scarf to breathe through if I am unwittingly exposed to diesel emissions or perfume. People with weather sensitive or pollution sensitive asthma that are living in a climate that gets extremely hot or dry in summers often need an air conditioner. When it gets cold and that is an asthma trigger breathing through a scarf and drinking warm liquids can be helpful.

Actions Indicated in Herbal Treatment of Asthma:

Anti-inflammatory herbs to bring down the swelling of the airways like Licorice (Glychirriza glabra) or Turmeric (Curcuma longa).

Herbs with bronchodilating and antispasmodic effects including; Ma Huang (Ephedra sinica), Sundew (Drosera rotundifolia), Wild Cherry (Prunus serotina), and Gumweed (Grindelia camporum)

Expectorants to help prevent mucus buildup in the lungs. Note that many herbalists advise against using stimulant expectorants as they can irritate things further but I think it depends on the client and the trigger. I have personally had great results using stimulating expectorants. Some examples of relaxing expectorants are Lobelia (Lobelia inflata), Licorice (Glycyrrhiza glabra), and Gumweed (Grindelia camporum). Two plants that could be classified as stimulating expectorants that I find to be indispensible are Mullein (Verbascum thapus) and Elecampagne (Inula helenium).

Demulcents to support the expectoration and soothe irritation. Great herbs for this are Licorice (Glychirriza glabra), and Mullein (Verbascum thapus) as they have an affinity for the respiratory system. However Marshmallow (Althea officinalis) or any other Mallow (Althea spp.) would also work.

Cardiotonics to support strain and lung congestion. My favorites are Hawthorne (Cratageus spp.) and Motherwort (Leonurus cardiaca). Both of these are great choices because they are also relaxing nervines.

Antimicrobials are really important if there is a respiratory infection or the possibility of a respiratory infection. Aniseed (Pimpinella anisum) and Hyssop (Hyssopus officinalis) are specific to the respiratory tract.

Relaxing nervines and adaptogen herbs are great as a preventative if symptoms are triggered by stress. If stress is not a symptom trigger, asthma symptoms and medications can cause stress, insomnia, and anxiety as well. An asthma specific nervine like Lobelia (Lobelia inflata) will work, however since Lobelia is a low-dosage herb I prefer to mix it with other nervines like Skullcap (Scuttelaria latiflora), Chamomile (Matricaria recuita), Motherwort (Leonurus cardiaca), Catnip (Nepeta cataria), or Passionflower (Passiflora incarnata). Several adaptogens particularly useful here are Holy Basil/Tulsi (Ocimum tenuiflorum) , Licorice (Glychirizza glabra) and Reishi (Ganoderma lucidum) because they are specific to the respiratory system. Others that can be helpful to include are Ashwaganda (Withania somniferum) for its nervine qualities helpful to those with insomnia, or Turmeric (Curcuma longa) which is an anti-inflammatory.

Alteratives are always good herbal allies. They will support our bodies in processing pharmaceutical drugs and are specially helpful for folks who have allergy or pollution related asthma. Alteratives can help open up the routes of elimination in the body and often help our bodies process waste and toxins. Most also have the added benefit of vitamins and minerals as well. Red Clover (Trifolium pretense) is my number one alterative choice because it has a respiratory affinity. It can help clear mucus from the lungs and you will breathe deeper. Stinging Nettles (Urtica doica) is a respiratory strengthener. Beloved to those of us with allergic asthma, nettle is perfect for bringing up respiratory congestion without irritating inflamed mucosa. Nettle can be juiced, made into a tea, or tinctured for use as a restorative tonic. Nettles is combined with Eyebright (Euphrasia), and Mullein (Verbascum thapus) for a tea used to combat hayfever triggered asthma. If corticosteroids are making you anxious, nervous, jittery, or spacey, Burdock (Articum lappa) or Dandelion (Taraxacum officinale) can help ground you as well as support the elimination of toxins.

Tinctures for Asthma Symptoms

Tinctures are great because they are portable and they keep forever. They are also a economical use of herbs that are scarce. They can help us use herbs on a regular basis that we don’t have access to year round. They can be used daily as a preventative or when symptoms present themselves. Keep in mind not every herb will work for every asthmatic or every symptom so it is good to try several. These can be used individually (also called “simple”) or in combination.

• Mullein (Verbascum thapus)
• Elecampagne (Inula helenium)
• Gumweed (Grindelia camphorum)
• Nettle (Urtica doica)
• Lobelia (Lobelia inflata)
• Red Clover (Trifolium pretense)
• Wild Cherry Bark (Prunella serotina)
• Holy Basil/ Tulsi (Ocimum tenuiflorum)

Combination Tincture Formula

1pt. Mullein

1pt. Nettle

1pt. Holy Basil/Tulsi

3/4pt. Motherwort

1/4pt. Lobelia

This combination tincture can be taken in a 30ml dose 2-3 X daily.

Herbal Tea Blends for Asthma Symptom Prevention

These tea blends are great for long-term maintenance as well as coping with mild asthma symptoms. They can be used before resorting to a rescue inhaler, or in conjunction with a rescue inhaler. To make a tea from these blends you take one tablespoon of tea blend per cup of boiling water and steep covered for 10-15 minutes. Honey is a soothing addition. Another way to take these herbs for long-term support is by infusion. An infusion is made by putting a handful (or roughly one ounce) of dried herb in a glass quart jar and filling it up with boiling water. Cover the jar and leave it to sit 4-8 hours. Overnight is perfect. You may want to include a wooden spoon in jar to prevent the glass from cracking. This has never happened to me but I have heard stories! If you do not have a quart jar you can leave the boiling water in the pot with the herbs to steep. Cover the pot. You will need four cups of water to equal a quart. Infusions are strong tasting medicinal strength teas. They can be taken with honey, hot or cold. You can also make the rock stars of these blends into simple infusions. A simple is when you use just one herb. Nettle, Mullein, Red Clover and Holy Basil make delicious simples for asthma maintenance.

Allergy and Asthma Free Tea

1pt. Eyebright (Euphrasia)

2pt. Mullien (Verbascum thapus)

3pt. Nettle (Urtica doica)

Breathe Calm and Deep

3 pt. Holy Basil/Tulsi (Ocimum tenuiflorum)

3 pt. Red Clover (Trifolium pretense)

1 pt. Hyssop (Hyssopus officinalis)

1pt. Catnip (Nepeta cataria)

1pt. Burdock (Articum lappa)

Tasty Lung Strengthening Tea

3pt. Mullein (Verbascum thapus)

2pt. Nettle (Urtica doica)

1pt. Holy Basil/Tulsi (Ocimum tenuiflorum)

½ pt. Peppermint (Mentha piperata)

Essential oils and Aromatherapy for Asthma

Essential oils can be very soothing and helpful for people with asthma symptoms. I encourage folks to experiment with the scents and actions essential oils have on them BEFORE they are having an asthma attack. Since having an asthma attack can make one much more sensitive to strong smells this is no time to experiment with new scents in my opinion. Two of the most effective ways to use essential oils for asthma symptoms are as rubs (in oil or salve, think vaporub!) or inhaled from the bottle or a piece of cloth. One can also put a few drops in the shower while bathing or in a diffuser if you have one. Essential oils to use will be ones that help you breathe deeply, and essential oils that are calming/relaxing to the nervous system.

Essential Oils to Use for Deep Breathing

• Peppermint
• Holy Basil
• Aniseed
• Hyssop
• Thyme (specifically effective for kids is Thymus vulgarus linololiferum)
• Rosemary
• Tea Tree ( be conservative and test beforehand as tea tree can irritate some people)
• Eucalyptus

Essential Oils to Calm and Relax

• Roman Chamomile
• Lavender
• Geranium

Inhalation Recipe (safe for children 5 and over)

8 drops of tea tree oil

7 drops of chamomile

OR

10 drops of lavender

10 drops of thyme

10 drops of peppermint

Mix into a combo blend and use 3 drops at a time in shower, diffuser or on a piece of cloth.

Oil/ Rub recipe

2 TBS of light neutral oil like grapeseed or almond oil

10 drops of lavender or geranium

10 drops of eucalyptus or tea tree oil

Rub on back. I like to add my favorite flower and gemstone essences to this.

Flower and Gemstone Essences for Asthma Symptoms

Flower essences are especially comforting during or immediately following the panic of an asthma attack. In particular Rescue Remedy (Bach’s Five Flower blend), and Star of Bethlehem are good for acute emergency situations. Comfrey and Wild Rose can be helpful if asthma attacks are stress or trauma related. Opal gemstone essence can help with over taxed adrenals and it is good to take after a course of prednisone. Lapis lazuli, Aquamarine, and Blue Tourmaline are all gemstone essences that are specific to the lungs and worth getting to know. These essences can be taken individually or added to tinctures, rubs and cups of tea.

The Value of Emotional Healing

Emotionally asthma has been associated with someone who has not been allowed to express their feelings and emotions. Someone who has a secret they were not allowed to tell. Someone who hasn’t been able to cry or yell or express their emotions in the way that they wanted or needed to. Talk therapy can really help someone who identifies with this description.

Conclusion

The value of holistic treatments for asthma symptoms cannot be overstated. Economically herbs are much cheaper and accessible to low income individuals and the millions of Americans without access to affordable health insurance. Many of these plants grow as weeds in our communities or are easily cultivated. The ability to manage symptoms and mitigate the effects of pharmaceuticals with herbs and other natural therapies improves the quality of life.

References

Asthma and Allergy Foundation of America. Website: www.aafa.org. Retrieved: June, 2011.

Balch, Phyllis A., CNC. Prescription for Herbal Healing. (192-194).

Centers for Disease Control and Prevention. Website: http://www.cdc.gov/VitalSigns/Asthma/.

Retrieved: June, 2001.

Hoffman, David, FNMH, AHG. Medical Herbalism – The Science and Practice of Herbal Medicine.

(330-334).

Potts, Billie. Witches Heal. (34, 40, 44-46).

Stein, Diane. Natural Remedy Book for Women. (108-113).

WebMD. Website: www.webmd.com/drugs. Retrieved: June, 2011.

Weed, Susun S.  Healing Wise. (174).

Worwood, Valerie Ann. The Complete Book of Essential Oils and Aromatherapy. (185).

Herbal Therapeutics June 27^th, 2011

Pathology Report:

Treating Infertility with Herbs & Nutrition

Part 1: Introduction

Infertility is a problem that effects about one in every six to ten couples in the United States, with the numbers steadily rising over the last couple of decades.  Medically, infertility is defined as a couple’s inability to conceive after stopping all forms of contraception for one year.  Studies differ on how often the issue is related to the man, the woman, or a combination of both: some say as high as 40% of problems with fertility are associated with the “male factor,” leaving the other 60% to be related to issues with the woman’s health and / or some combination of them both.  There are many factors that can affect a couple’s fertility, such as decreased sperm count, diet, pathological issues within the woman’s body such as endometrosis or a malpositioned uterus, emotional and psychological factors, stress and overwork, etc.  Although the many factors involved in a couple’s infertility may be complicated and difficult to diagnose and discern, herbal care and nutritional counseling can be very effective in assisting couples to conceive  — even when there is no specific “cause” for a couple’s infertility that can be easily identified as the culprit.

Part 2: Some Possible Causes of Infertility

If a couple has problems conceiving a child after a year of attempting to do so, many natural practitioners and most allopathic medical doctors will recommend testing to look into whether or not there are pathological reasons for conception to be blocked.  Western medical science, with its ability to do blood tests for hormone levels and allergy tests, etc., can be very helpful in this regard, but it is not the only avenue for investigation.  Having the woman chart her basal body temperature, cervical mucus, cervix position, and other fertility signs a la Toni Weschler’s book Taking Charge of Your Fertility can also lead to some very insightful information as to what is happening within the woman’s body that is inhibiting conception.   Charting fertility signs can help a woman understand if she is having annovulatory cycles (not ovulating), conceiving and then naturally aborting the child, or none of these things.   This information can be very helpful to the herbal practitioner in creating individualized formulas and recommendations for the couple (more on that later).

However, UK Herbalist Carol Rogers says that “ A greater proportion of infertility occurs in women whose reproductive function is otherwise normal than as a result of any of these abnormalities.”[i] Many couples who have difficulty becoming pregnant suffer from a combination of sub-clinical conditions. These conditions can’t cause infertility on their own but — in combination — they can substantially reduce a couple’s probability of conceiving.  For example, a gluten intolerance alone may not cause infertility, but the the resulting inflammation in the gut can minimize your nutrient absorption and lead to deficiencies in nutrients you need for optimal sperm, egg and hormone production and a healthy pregnancy.  Brooklyn acupuncturist and herbalist Karen Vaughan notes that there are a diverse range of causes for infertility, some of which may be ‘caught’ by medical testing and some which may be more mysterious.  “Missing minerals, insulin resistance, lack of essential fats, lack of protein, strong fears of motherhood or pregnancy, low quality menstrual cycles, silent infections like chlamydia or gonorrhea, blocked fallopian tubes, PCOS, aging eggs and sperm, and many other factors affect fertility and the remedies are all different.”[ii]

Some of the most common factors affecting fertility in women are:

e    Retroverted or “Tilted” Uterus: In most women, the uterus is tipped forward, towards the bladder.  However 1-in-5 women has a retroverted or tipped backwards towards the spine.  Most fertility doctors no longer consider this a factor in infertility, although some natural practitioners may suggest bodywork such as Mayan Abdominal Massage (rhibozo massage) to ensure optimum fertility and increase the chances that once conception occurs, the woman will not miscarry.

e    Prolapse & Fibroids: Fibroids are common benign tumors in the uterus, generally associated with hormonal imbalance and an excess of estrogen.  A recent study found that Fibroids in general, regardless of location, were associated with a 15% reduction in pregnancy rates, a 30% reduction in live birth rates, and a 67% increase in miscarriage rates when compared with controls without fibroids.[iii]

e    Cervical problems: The cervix can also be affected adversely and cause sterility. Infection or excess mucus from inflammation can expel the sperm, or polyps may prevent the sperm from entering the uterus.

e    Fallopian Tube problems: Fallopian tube blockages may obstruct the egg from passing down into the vagina.  This can be caused by genetic predisposition or because of infection, such as salpingitis (inflammation of the fallopian tubes), endometriosis, and TB.  These infections can cause the thickening of the tubes which either narrow or completely block the passages, or they can cause the tubes, uterus and ovaries to become matted together by adhesions, or in the case of endometriosis, by growths of tissue from the uterus.

e    Vaginal mucus: if too viscous can impair fertility

e    Polycystic Ovarian Syndrome (PCOS): PCOS is a very common condition affecting women of reproductive age, affecting 5-10% of premenopausal women.  It has a variety of symptoms, including weight gain, annovulatory cycles, irregular menstruation, hyperandrogenism (overproduction of androgens), hirsutism (increased body hair), ovarian cysts, and insulin resistance.  A woman may have some but not all of these symptoms – she may be diagnosed with PCOS even if a pelvic exam does not indicate the presence of cysts.

e    Endometoriosis: Another very common reproductive condition that may affect fertility; effects approximately 5-10% of all women.  Endometriosis involves tissue that forms the lining of the uterus growing in other parts of the pelvis and sometimes even outside the pelvis entirely.  Interestingly, Christiana Northrup calls Endometriosis, “the illness of competition.”  She traces it to when “a woman’s emotional needs are competing with her functioning in the outside world.  When a woman feels that her innermost emotional needs are in direct conflict with what the world is demanding of her, endometriosis is one of the ways that her body tries to draw her attention to the problem.”[iv]

e    Emotional problems: Where emotional problems cause tension and anxiety, or when just wanting to conceive is producing psychological blockages to conception, herbal remedies may well be helpful. Susan Weed highly recommends Motherwort (Leonorus) when emotional issues seem to be blocking conception, especially when nervousness or ambivalence about the transition into motherhood is a main factor.

e    Debility: David Hoffman cites lowered energy and general fatigue as a common issue with fertility.  “Where illness, malnourishment, fatigue, and conditions such as anaemia, anorexia and kidney problems have lowered vitality and produced a state of debility which has affected fertility, there are many herbs which can help to build up the strength of the generative organs. Bitters, tonics and adaptogens are actions to consider. The specifics will depend upon the individual concerned, but application of the model for remedy selection will usually clarify this.  True Unicorn Root (Aletris farinosa) is considered beneficial for habitual miscarriage due to chronic weakness. It can be used safely throughout pregnancy. It acts to stimulate the uterus and ovaries and is commonly used for infertility and impotence.”[v]

e    Immune health: Imbalances in the immune system can inhibit conception. Treating low-grade infection in the genito-urinary system and addressing any autoimmune factors can be an important factor in fertility health.  Sometimes a woman’s system builds up antibodies against her partner’s sperm, or the fetus itself.  Also, some STD’s – often asymptomatic – can affect fertility.  One such STD is a Chlamydia infection. In men, a Chlamydia infection can lead to sperm abnormalities including sperm antibodies. In women, it can lead to scarring, blocked tubes and miscarriage.  One study found 60% of asymptomatic male partners of infected females attending a fertility clinic were found to be infected with Chlamydia.

e    Endocrine System Health: Disorders within the endocrine system that affect fertility can include hyper or hypo thyroidism, pituitary dysfunction, and signs of adrenal weakness. The endocrine system plays a huge part in hormonal balance.

e    Body weight: Being underweight or overweight in women can lead to issues with hormones and the ability to conceive.  Further, the effects of fad dieting and the resulting labile weight levels disrupts the delicate balance of hormones. Nutritional deficiency, common in many fad diets, may result in amenorrhea and anovulation. For optimal reproductive health, a woman should ideally have no less than 25% body fat. This becomes especially important after menopause when the fat tissue becomes a major source of estrogen, preventing bone loss and ensuring the skin and mucus membranes stay healthy.  On the other hand, obesity can also lead to hormonal imbalances, and obese women more likely to suffer from the effects of excess androgens (PCOS).

e    Adrenal Fatigue: Herbalist Rosalee De La Foret cites adrenal fatigue as a common issue for couples struggling with conception.  “In my practice I often see adrenal fatigue or, in TCM terms, kidney yang deficiency, as an underlying cause of infertility. Kidney yang deficiency is a whole other topic in itself but it is addressed with herbs, lifestyle, and nutritional changes that can help restore balance to these depleted individuals. Adaptogen herbs, nutrient dense foods, healthy sleep habits, regular exercise, and stress management tools are commonly suggested.”[vi]

e    Environmental Health: The health of the environment plays a large role in fertility health. Pesticides, heavy metals, xenoestrogens, and radiation have all been implicated in infertility and with miscarriage.  Some researchers speculate that the rate of infertility may be increasing, especially in comparison to rates previously experienced in pre-industrialized society. Much of this concern is attributed to exposure from man-made, industrial chemicals that contaminate the environment, including solvents (e.g. benzene), polyhalogentated aromatic hydrocarbons (PHAHs, e.g. benzo[a]pyrene, PCBs, dioxins), herbicides (e.g. 2,4-D) insecticides (e.g. dibromochloropropane), fungicides (e.g. vinclozolin), metals (e.g. lead, cadmium), and plasticizers (e.g. bisphenol-A). In large part the concern relates to chemicals called xenoestrogens that have an estrogen-like activity, but these chemicals can have other effects as well, such as increasing or decreasing the secretion of estrogen and androgens, inhibiting hormonal activities generally, or causing direct damage to reproductive tissues.  “Humans cannot pollute this planet and their own bodies without consequenes, and infertility is one of them.  Conditions on the Earth may not favor fertility the way they used to.  It’s as thought the collective species brain were generating a great deal of energy toward making many women and men infertile, due to the stresses of today’s families, social environments, and personal addictions, and to the stress of the planet itself.”[vii]

e  Stress: In both men and women, stress can negatively affect sexual performance and fertility. With stress the activity of the hypothalamus is decreased, resulting in diminished GnRH, FSH and LH secretion, and decreased levels of the gonadotropins such as estrogen, progesterone, and testosterone. Statistics suggest that about 5-10 % of infertility is stress related. This problem obviously becomes compounded if drugs and alcohol are used as a coping mechanism.[viii]

e  Age: Although age does have an impact on fertility in women, Susan Weed and Carol Northrup both caution us not to focus on this aspect of infertility too much, as it is perhaps over-emphasized by infertility doctors and the medical establishment.  “Contrary to current opinion, having children in your forties is ordinary and common worldwide,” Weed notes. “What is unusual and unique to our time is having a first child in one’s forties. Our mothers, mothers, mothers were having their fifth or eighth or tenth child when they were in their forties, not their first.  If people tell you it just isn’t done, close your eyes and call upon the spirit of your great, great, great, great grandmother, then smile and tell them it seems utterly ordinary to you.”

e    Sexual Activty / Libido: A healthy sex life is essential to conception.  Many studies have shown that it isn’t simply the act of sex itself but also orgasm that is a factor in conception.  “Orgasm on the part of the male is necessary for fertilization. The woman’s orgasm does increase the possibility of conception. Women who experience orgasm after their partner (up to 40 minutes after his ejaculation) have the very best chance of becoming pregnant.”[ix]

While many of the factors above may affect men as well (such as environmental toxicity, debility, and endocrine health / hormonal balance) some factors that specifically affect male fertility are:

e    Sperm count: The commonest cause in men is no sperm or a low sperm count. This may be caused by numerous factors including an infection after puberty which was accompanied by a high fever, unrepaired undescended testicles, taking certain drugs, trauma to the testicles, or exposure to large amounts of X-ray. For the most part however, a low sperm count tends to be related to more easily reversible conditions. A long illness or a chronic infection may lower general health, as could poor diet, strenuous physical exercise, lack of exercise, too much smoking and drinking, over-weight, overwork, tension and fatigue. A common reason for a low sperm count is abnormal temperature regulation in the testicles, which function at a temperature slightly lower than the rest of the body.[x]

e    Low sperm motility:  This makes them unable to travel from the vagina, through the fallopian tubes to fertilize the ovum. This tends to be related to some of the above factors, and may also be due to enlargement of the prostate gland, as well as an imbalance of male hormones in the body. The vessels along which the sperm travel in men could be blocked by an inflammatory or infectious process or by varicosity in the area.[xi]

Part 3: Diet, Nutrition and Fertility

Many of the causes of infertility are related to diet (PCOS, adrenal fatigue, general toxicity).  Luckily, many of the things that couples can do to increase their likelihood of conception are also related to diet and nutrition.  In general, conceiving a child is similar to cultivating a garden; feeding ourselves healthy, whole foods high in nutrition and low in sugars and toxins is like feeding the soil that the seeds will be nestled in before emerging into the sunlight.

Alcohol, caffeine, tobacco and other intoxicants:

Pregnant women have long been told that alcohol can effect the fetus, but Todd Coldecott says that alcohol in general is unhealthy for anything to with reproduction. “Even moderate consumption, or 1-2 glasses of wine per week can increase prolactin levels and suppress ovulation.  The elevation of prolactin also occurs with the usage of antidepressants, analgesics, hallucinogens, and marijuana. Tobacco too poses problems for women, and although no one knows exact link, female smokers generally have decreased estrogen levels, poor cervical mucus, a higher risk of pelvic infection, and an increased incidence of ectopic pregnancy and miscarriage.  Additionally, nicotine appears to toxic to sperm, and thus smoking can interfere with fertility. Coffee is another vice, and women who consume one cup of brewed coffee a day are half as likely to conceive. Caffeine is also implicated in cyclic breast pain and fibrocystic breast disease.”[xii]

Coldecott says that men can tolerate more alcohol without effect on fertility, but excessive alcohol conception (which he defines as 2-3 pints of beer per day) can lead to poor sperm motility and depressed libido. In addition, “the ensuing damage to liver function liver also causes estrogen levels to rise and antagonize the activity testosterone. Tobacco also poses certain risks, and about two-thirds of impotent men are smokers. Nicotine inhibits blood flow to the penis, and only 1-2 cigarettes will cause an immediate impairment of circulation.”[xiii] Men who smoke marijuana frequently typically demonstrate lower testosterone levels than average, as well as poor sperm motility. Other drugs, such as cocaine and amphetamine inhibit parasympathetic activity and can result in premature ejaculation.

Gluten, Soy & Wheat

The incidence of gluten intolerance or celiac disease is higher in women experiencing unexplained infertility than among the general population.[xiv] Gluten intolerance is not only related to unexplained infertility, but also to recurrent miscarriage, and intolerance to gluten, often undiagnosed, contributes to nutrient malabsorption as those suffering from the intolerance do not readily absorb micronutrients like iron, zinc and folic acid which are critical to reproduction.  Strict adherence to a gluten-free diet usually resolves symptoms including unexplained infertility and recurrent miscarriage.  Gluten is a protein found in various grains including wheat, spelt, barley and rye.

Another common allergen that is damaging to reproductive health is soy.  Soy is a potent source of xenoestrogens.  Soy isoflavones can create potent, adverse effects on both the male and female reproductive systems – particularly in their early development.[xv] It’s important that women trying to conceive avoid foods that list soy, soy lecithin, soy protein, soy flour, texturized vegetable protein (TVP) – taking special care to avoid soy milks and soy-based meat substitutes.

Refined Sugars & Insulin Intolerence

Vaughan argues that there is a strong connection between insulin resistance and infertility, even when there is no PCOS. Too much insulin in the blood promotes insulin growth factor, which causes cysts and fibroids to grow, and elevated insulin levels can also contribute to abnormalities in the HPA axis, which affects hormone levels.  Insulin resistance is caused by eating too many sugars and carbohydrates and not getting enough healthy nutrition – especially Omega 3 fats – to balance it out.

Vaughan recommends that women with reproductive health issues follow a low-glycemic diet that limits consumption of refined sugars, which she says “may improve fertility and pregnancy outcome.  Sugar and refined carbohydrate consumption plays a particularly devastating role in polycystic ovarian syndrome.  Women with polycystic ovarian syndrome may see improvements in their fertility by increasing protein and restricting or eliminating simple, refined sugars.”[xvi]

Dietary Supplements

In addition to a rising diet rife with sugars that lead to insulin issues, Vaughan also notes that the reduced mineral nutrition in our foods can be detrimental to fertility.  “Between the mid 1970s and mid 1990′s the USDA tested the nutritional content of food and found most minerals declined by a third due to soil depletion.  Magnesium is one of the most important, but zinc, boron and a number of trace minerals are also significant.  I suggest at least 500mg of magnesium plus a multi-mineral or trace concentrate supplement.”[xvii] In addition to magnesium supplementation, Vaughan recommends that couples working with fertility and conception should also consider taking fish sufficient to provide 1000mg of DHA, Vitamin D (5000-10,000 iu per day), and a prenatal vitamin with folic acid in it.   Vitamin D has been shown to reduce pregnancy complications such as premature deliver and preeclampsia, and may also reduce the risk of Autism and Type 1 Diabetes in newborns.

Susan Weed also notes the importance of Vitamin E in addressing infertility issues, especially when working with women over 40.  “Vitamin E is an especially critical nutrient for fertility after forty and freedom from birth defects. Freshly-ground wheat flour, cold-pressed oils, and nut butters are all good sources of vitamin E, as are stinging nettle infusion and most cooked seaweed, such as kelp. The man’s vitamin E level has as much, if not more, bearing on freedom from birth defects as does the woman’s vitamin E level.
”  She also recommends boosting nutrition overall by drinking herbal infusions infused overnight.  “Women who drink 2-4 cups of stinging nettle infusion daily and eat cooked leafy greens as well as lettuce salads are getting the abundant folic acid, calcium, magnesium, and other minerals needed to create a healthy baby. (Tinctures, pills, and teas contain little or none of these important nutrients.)”[xviii]

The Pre-Conception Diet

Many herbalists, naturopaths, and other health practitioners recommend that couples working with fertility issues also consider going on a pre-conception diet for 6 months to a year before attempting to conceive, especially if the couple has miscarried in the past or if there are specific pathological reasons interfering with establishing a pregnancy (such endometriosis, fibroids, annovulatory cycles, etc).

Most pre-conception diets have similar tenants to the Traditional Nutrition regime created by Weston Price in the 1900s.  Some common attributes include:

e    Raw, grassfed dairy foods (milk, cheese, yogurt, kefir, butter, ghee, etc.) and/OR seafood (fish and shellfish).  Fat, including butterfat, is an important source of fat soluble vitamins – the very nutrients that are vital to the reproductive process.   Skim and part-skim dairy products lack butterfat and the life-giving nutrients it contains.   A recent study of over 18,000 women found that skim and low-fat dairy products may actually increase the risk of anovulatory infertility, while full-fat dairy products actually decrease the risk of infertility.  Women who eat at least one portion of high-fat dairy food per day have more productive ovulation, by 27% than women who eat low-fat dairy. Women who eat 2 servings or more of low fat dairy have 85% more ovulation-related infertility.  It’s important that all dairy comes from organic, pasture-raised cows.  In addition to reducing a woman’s exposure to excess chemicals and hormones, “the fat from pasture-raised cows contain has as much as five times the CLA (a fatty acid which is a potent anti-cancer agent, muscle builder, and immunity booster) as fat from grain-fed cows.  The Omega 3 essential fatty acids are found in similar proportions to deep sea fish.  Grass-fed milk contains rumenic acid (a CLA), DHA, vaccenic acid, branched chain fatty acids, butyric acid, lecithin, cysteine-rich whey proteins, calcium, iodine and vitamin D all of which have value from reducing cancer to increasing fertility.”[xix]

e    Healthy Fats: One of the best things a woman can do with her diet to help her increase her ability to conceive is make sure she is getting enough healthy fats. “Fat is the substance of  the phospholipid bilayer that surrounds cells, including eggs, and lets nutrients and sperm through the membrane.  Fat in the form of cholesterol makes up the building blocks of hormones needed to trigger ovulation and implantation.”[xx] Good healthy fats are butter, lard, coconut oil, olive oil, the fat in nuts and seeds (and nut butters), and other animal fats.  Avocados are another good food to get good fats. Avocados and nuts provide a lot of Vitamin E, which is vital to conception.

e    It’s important to avoid transfats, however, which impair fertility. Scientists from the Harvard University School of Public Health advise women wanting to get pregnant to avoid all trans fats, as they may increase the risk of infertility by up to 70%.

e    Organ meats: from organic, grassfed animals one or two times a week (liver, liver pates, heart, kidney, etc).  Couples can try mixing ground organ meats into ground beef for spaghetti, etc., if they aren’t used to them.

e    Animal protein: It’s important that this includes both the meat and the fats. Fish and shellfish are also good (oysters, calms, crab, lobster) as they supply idodine – an idodine deficiency can cause infertility.  Eggs, especially egg yolks, can also be very helpful.

e    Vegetables & Leafy Greens: fresh or lightly cooked vegetables (serve with plenty of butter, homemade dips, or olive oil and vinegar dressings over your salads) are a good source of nutrition, vitamins, minerals, anti-oxidants, and healthy carbohydrates.  Leafy greens provide folate (also in chicken, fish, fruit, nuts, and lentils) – which helps prevent birth defects.

e    Fermented foods: sauerkraut, pickles, kimchi, and kombucha, anything lacto-fermented.

e    Bone broths: Bone broths bring lots and lots of minerals to the diet, and also cleanse the body and help digestion.

Part 4: Treating Infertility with Herbs & Nutrition

When working with a couple affected by infertility, one of the most important (and perhaps counter-intuitive) suggestions that we can offer as herbalists is to stop trying to conceive, at least, for a certain period of time.  Couples should spend 4-6 months trying to tonify the body and avoid conception.  During this time, the woman should monitor her  ovulatory cycle in this time a la the fertility awareness method.  Both partners should also take up the pre-conception diet and test and supplement for nutritional deficiencies, especially magnesium, vitamin D, vitamin C, vitamin E, Selenium, Zinc, B vitamins – especially for vegetarian women.

Rogers recommends a three-step process of treating infertility with herbs:

1. Use hormonal normalizers prescribed until cycle is regular: chaste berry, wild yam, false unicorn root.
2. Next, nourishing herbal tinctures or teas are taken for several months: alfalfa, nettles, red clover, raspberry leaf, peony root, rehmannia, schizandra, dong quai.   Red clover and red raspberry are high in calcium and magnesium, two minerals especially good for conception.
3. Finally use uterine tonics for 2 months or until conception.: false unicorn root, squaw vine, true unicorn, blue cohosh, golden seal.
4. For men: reduce use of toxic pollutants, decrease stress.  Increase Vitamin A, E, Zinc, and Manganese (up to 50 mg of zinc daily, found in large amounts in sperm, testicles and prostate). Herbal tonics of panax ginseng, schizandra, he shou wu, saw palmetto and some of the nourishing herbs for women work as well.[xxi]

De Foret recommends that couples see the failure to conceive as “a symptom of an underlying cause.  Couples seeking holistic treatment need ot understand that while the end-result may be conception followed by birth, the big picture goal is to create a healthy balance in the entire body.”  Her model utilizes bi-phasic formulation that matches different herbs to coincide with where the woman is in her cycle and what support is most helpful at that time. The idea is that in the first two weeks of the menstrual cycle (follicular phase) a woman is building estrogen hormones in her body. The last two weeks progesterone is building (luteal phase).  “Using a bi-phasic formulation you can then support the woman’s natural cycle. One formula is created for the follicular phase of the cycle and one formula is given for the luteal phase of the cycle. Other considerations may also be present in this formula including liver health, immune support, adrenal support, etc.”[xxii]

Vaughan takes herbal formulation by stages one step further, advising that herbalists use the information from charting to develop the herbal recommendations and formulation for the woman.  She advises to check and see if the follicular phase is too short (leading to shorter cycles overall), if the luteal phases is too long, or if the spike in temperature that indicates ovulation is not high enough to actually release an egg, etc, and use these assessments to choose herbs that target that part of the cycle to support.  As an acupuncturist trained in TCM, she advises using “yin tonifying herbs for the follicular phase and yang tonifying herbs for the luteal phase, with certain herbs specific to ovulation used at that time.”

…A woman goes through more than two different hormonal processes during her menstrual cycle. In the first phase she ripens the egg and builds the endometrium in her womb, which depends upon  Kidney Yin and Blood.  In the second , Liver Q and Blood movement govern ovulation.  In the third phase  Kidney Yang and Spleen Qi regulate the luteal stage or hold the pregnancy if it occurs.  In Phase 4, when PMS is most prevalent, Liver Qi helps the premenstrual transformation.  And Phase 5 is menstruation, covered by Blood and a little Qi to keep it moving.

It is not necessary to come up with five formulas unless the cycle is seriously disturbed.   If only one part of the cycle is not functioning well, you can target it.  This is not only done by, say giving vitex which increases progesterone during the luteal phase.  Instead I might use magnesium and zinc throughout the cycle as these help the body form progesterone itself.  Or I might add a little warming cinnamon and maca to the Yin phase of the formula in order to give the yin enough oomph to transform to yang at ovulation.[xxiii]

Vaghan’s Herbs for the Follicular Stage (yin): goji berries, slippery elm, peony root, black sesame seeds, seaweeds, shatavari, Dong Quai.

Ovulation Herbs: goji berries, peony root, damiana, bluperum

Luteal Stage Herbs (yang): Cinnamon, ginger, vitex

Premenstrual Herbs: Cilantro, licorice, Xiao yao san

Menstruation Herbs: Topical frankincense, turmeric, San qi.

Vitex agnus castus (Chaste Tree Berry): Vitex is a progesterone agonist which can help to minimize the risk of miscarriage. In addition, it can also stimulate ovulation. It works specifically by enhancing pituitary function, thus improving ovarian function. Research carried out in the University of Gottingen in Sweden, found that although it does not contain the hormone progesterone, it affects the pituitary gland in such a way that it corrects and regulates the secretion of progesterone from the ovaries. Vitex also corrects any hormone deficiency of either estrogen or progesterone.

Chamaelirium luteum (False Unicorn Root) also has the effect of correcting hormonal imbalances. In Britain, the most frequent use of this remedy is for female infertility, as well as impotence on the part of the man. Herbalists have been known to warn people of the potency of this plant should they not want to conceive! It is an effective tonic to the uterus and ovaries, and is useful to redress almost any imbalance in either male or female reproductive systems. It helps to prevent miscarriage, uterine hemorrhage and over-relaxed conditions of the uterus, even to the extent of prolapse.

Angelica sinensis (Dong Quai):

Avena sativa (Milky Oats): moistening, nutritive tonic

Urtica dioica (Nettles): high mineral content, restores general health

Trifolium pratense (Red Clover):  A strong overnight infusion of red clover, or red clover mixed with nettles and oatstraw has pushed many women over the brink from infertility to fertility.  This seems to work best when a little extra nourishment is needed in an otherwise healthy woman.   “Red clover is the single best remedy for women over forty who want to conceive but can’t — even if there are medical reasons for not conceiving such blocked tubes, diabetes, ovarian cysts, internal scaring, endometriosis. There are many heart-warming success stories I could share about red clover! But suffice to say, drinking 2-4 cups of the infusion of the dried blossoms (neither tincture nor tea nor pills will work for this application) seems to do wonders for fertility, no matter what your age.”  — Susan Weed

Leonorus cardiaca (Motherwort): Calmative, especially for issues around motherhood.

Symphytum uplandica (Comfrey): Again from Susan Weed,  “the single most important herb for pregnant women over forty is comfrey. The leaves of the mature plant contain an abundance of constituents beneficial to mother and babe, including generous amounts of minerals, alantoin, proteins, and many vitamins. The minerals in comfrey help insure  healthy nervous system growth; the fetus’s developing brain uses the proteins. And the alantoin helps the mother’s tissues become stretchy and elastic. 

Aging can lead to increases stiffness and brittleness in bones and muscles, making pregnancy more arduous and painful, labor slower and more difficult, and injury more likely during birth. The hormones of pregnancy, which help soften and relax the pelvic tissues, may not be produced in adequate amounts. Comfrey comes to the rescue! Comfrey creates flexible and strong tissues throughout the body especially mucus surfaces (including intestines, uterus, bladder and vagina) the bones, the ligaments and tendons, and the skin.

Regular use of the leaf infusion, at least a quart a week, promotes a safe delivery by:strengthening uterine muscles and preparing them to work easily and well; strengthening perineal tissues so they become resistant to tearing; strengthening uterine ligaments so the uterus does not prolapse; strengthening the bladder and increasing resistance to bacterial infection; strengthening the vagina and helping to promote an environment hostile to infection; providing easily assimilated minerals to prevent eclampsia and other complications; helping the bones of the pelvis flex and open during birth; increasing iron in the blood and thus forestalling post-partum hemorrhage.

Adaptogens to assist the HPA-axis function:

Female: Cordyceps, licorice, rhodiola, shatavari

Male: American ginseng, ashwagandha, asian ginseng, cordyceps, he shou wu, lucium, rhodiola, rhaponticum, and shilajit.

Asian ginseng – promotes estrogen

Astragauls – sperm motility

He shou wu – sperm count and motility

Schisandra: increaseses pelvic circulation, tones repro

Ashwagandha – stablilizes HPA axis, reduces adrenaline & cortisol, helps with thyroid.

More helpful herbs from Carol Rogers: True Unicorn Root, Squaw Vine, Blue & Black Cohosh, Wild yam, Red Raspberry, Alfalfa

[i] Rogers, Carol.  The Women’s Guide to Herbal Medicine. 1997.  Retrieved from: http://www.womens-herbal-guide.com/publications.htm

[ii] Vaughan, Karen.  “Staging Herbal Formulas to Enhance Fertility.”  August 13^th, 2010.  Retrieved from: http://www.acupuncturebrooklyn.com/alternative-health/staging-herbal-formulas-to-enhance-fertility

[iii] Kovak, Peter.  “Fibroids and Infertility: An Updated Systematic Review of the Evidence.”  2009.  Retrieved from: http://www.medscape.com/viewarticle/701937

[iv] Northrip, Christiane.  Women’s Bodies, Women’s Wisdom, p172. Bantam Books, New York, 2002.

[v] Hoffman, David. “Infertility.”  Retrieved from http://www.healthy.net

[vi] De La Foret, Rosalee.  “Holistic Herbal Perspectives for Challenges with Fertility,” 2010.  Retrieved from Methowvalleyherbs.blogspot.com

[vii] Northrup, p 413.

[viii] Caldecott, Todd.  “Fertility Inventory.”  Retrieved from http://www.toddcaldecott.com/

[ix] Weed, “Fertility Over Forty.”

[x] Hoffman, David.

[xi] Hoffman, David.

[xii] Coldecott, Todd.

[xiii] Codecott, Todd.

[xiv] Jenny, “Unexplained Infertility.”  Retrieved from www.nourishedkitchen.com

[xv] “Unexplained Infertility.”

[xvi] Vaughan, Karen, “Insulin Resistance and Infertility.”  2010.  Retrieved from: http://www.acupuncturebrooklyn.com/alternative-health/insulin-resistence-and-infertility

[xvii] Vaughan, “Staging Herbal Formulas to Help with Fertility.”

[xviii] Weed, Susan, “Fertility Over Forty.” 2000.  Retrieved from: http://www.susunweed.com/Article_Fertility_After_Forty.htm

[xix] Vaughan, “Full Fat Dairy Helps Ovulation in the Infertile.” 2010.  Retrieved from: http://www.acupuncturebrooklyn.com/alternative-health/full-fat-dairy-helps-ovulation-in-the-infertile.

[xx] Vaughan, “Full Fat Dairy Helps Ovulation in the Infertile.”

[xxi] Rogers, The Women’s Guide to Herbal Medicine.

[xxii] De Foret, “Holistic Herbal Perspectives for Challenges with Fertility.”

[xxiii] Vaghan, “Staging Herbal Formulas…”

Here is a List of 2011 student-led walks. All walks are free of charge and last from 10 am – 1 pm. Check back for more detailed descriptions as dates draw closer.

Saturday May 21: Briones Park

Sunday May 22: Mt. Diablo

Sunday May 29th: Huckleberry Preserve

Saturday June 4th: Grizzly Peak

Saturday June 18th: Redwood Regional Park

Sunday June 19th: Huckleberry Preserve

Friday Night Lectures are 7-9 pm and Saturday and Sunday workshops are 10-5 pm. To sign up, please visit the “Classes & Registration” page under the “School” tab. Sign up for lecture at least 24 hours in advance (by Thursday 7 pm day before) for the $10 price.

Our speakers by month will be:

• January 7-8th- David Hoffmann: Evolving Western Herbal Traditions
• February 11-13th- Sage La Pena: Native American Herbal Healing
  
• March 11-13th- David Crow: Principles of Ayurvedic Wisdom
• April 8-9th- Luisah Teish & Xochipala Maes-Valdez: Indigenous Healing of Africa and Mexico
• May 13-15th- Jeff Nagel: Taoist Herbal-Nutrition & Chi Kung Healing Traditions
• June 10-11th  Tibetan Healing Wisdom

Reserve your place for lectures and workshops now! Go to our classes page to register for the individual event you would like to attend and pay through PayPal!

Friday night lectures are $10.00 in advance (at least 24 hours before lecture) and $20.00 at the door. Weekend workshops are $100.00 a day.

Ohlone Center Therapeutics Program, June 2010

According to the journal, Hospital Pharmacist, one percent of the population will develop bipolarism in their lifetimes.  The World Health Organization lists it as the sixth leading cause of disability in the world and it affects approximately 5.7 million adult Americans.  This is not a modern affliction as the connection between states of depression and mania, which vastly defines bipolarism, has been noticed since the second century. It was first coined Manic Depressive Psychosis and defined as a psychiatric disorder in 1875 but it wasn’t until 1913 that it gained a clear distinction from schizophrenia (http://www.caregiver.com).  However, bipolarism didn’t become a major mental disorder diagnosis until the era of mental health medicalization and drug therapies was ushered in during the early 1950’s with the development of the Schizophrenic drug, Chlorpromozine (Whitaker). From this point on bipolarism, or Manic Depressive Disorder as it was known, became a much more common diagnosis and psychopharmaceuticals were considered the first line of treatment for diagnosable mental disorders and continues to be the main protocol in modern psychiatry.

In the United States, approximately 38 percent of adults (about 4 in 10) and approximately 12 percent of children (about 1 in 9) are using some form of Complimentary and Alternative Medicine (CAM). With the rising cost of health insurance, the increasingly dissatisfying results from pharmaceutical or surgical therapies, more Americans are looking for better and cost effective ways to take care of themselves. In 2007, Americans spent nearly 15 billion dollars on natural non-vitamin or mineral products like herbs and fish oil (http://nccam.nih.gov).  With this rise in the use of complimentary medicines to achieve and maintain health, and the potential increase in diagnoses of bipolarism there is a high likelihood that an herbal practice or clinic will include clients with a bipolar diagnosis. Though the advent of prescription psychopharmaceuticals has inarguably helped and even saved the lives of many people suffering from mental disorders, these “wonder drugs” do not come without cost.  Many have exchanged mental stability or functionality for a slew of serious, potentially lethal negative drug affects.  For most it is a barter that they will pay and see it as a necessary sacrifice. Yet, holistic herbal medicine has proved to be an excellent way for mental health clients to bring more balance to this pact. Most of these clients will seek out herbal medicine not necessarily to replace their pharmaceuticals but to address the side affects of these drugs and to “just feel better” all around.  Under the holistic guidance of a trained herbalist, these clients will be seen as a whole person and not simply a diagnosis. They will examine the effects not only of the drugs they are taking but the food they eat, their emotional and spiritual lives, and the way they relate to their world. This can enable the bipolar sufferer to see their health in a more holistic way as well.  In this paper, I will examine the current definitions and theories of causality of bipolar disorder, look at holistic therapies that herbalists can incorporate into their work that will address constitution and work with pharmaceutical therapies in order to reduce the side affects and enhance drug efficacy, and explore strategies to more sustainable community support for bipolar people, all in an effort to help clients achieve a broader sense of wellness.

According to the DSM, bipolar (BP) diagnosis is divided into BP I, BP II, and cyclothymic disorder (also known as “rapid cycling”) with the main differences being which altered mood, mania or depression, is more pronounced in the client and the length of each mood cycle.  However, each diagnosis must contain a certain amount of both states and fulfill the criteria for Major Depressive Episode and/or Manic Episode.[1] Bipolarism is diagnosed by a trained psychiatrist who examines the clinical symptoms and then determines if the client fulfills the necessary number of criteria for both manic and depressive states in order to distinguish it from ordinary mood swings or another psychiatric diagnosis. Startlingly, the DSM states that a person only needs one occurrence of these episodes to qualify for bipolarism.  Seemingly, the little diagnostic criteria and the money to be made by the pharmaceutical companies off drugs prescriptions may be important reasons why there is such a rise in incidents of the disorder.

As described by Bipolar Magazine, bipolar I disorder is characterized by one or more manic episodes or mixed episodes-symptoms of both mania and depression occurring nearly everyday for at least one week-and one or more major depressive episodes. Bipolar I disorder is the most severe form of the illness, marked by extreme manic episodes (extreme highs) and is also referred to as the classic Manic Depressive Disorder.  It usually has longer building cycles culminating in severe manic or depressive episodes.  Bipolar II disorder is characterized by one or more depressive episodes (extreme lows) accompanied by at least one hypomanic episode. Hypomanic episodes have symptoms similar to mania but are less severe and must be clearly different from a person’s non-depressed average mood.  This disorder is often characterized as more depressive and while the rates of BP I do not differ between men and women, the rates of BP II tend to be more prominent in women.  Cyclothymic disorder is characterized by chronic fluctuating moods with periods of hypomania and depression. The periods of both depressive and hypomanic symptoms are shorter, less severe, and do not occur with regularity as experienced with bipolar I or II. However, these mood swings can impair social interactions and work. Many people with cyclothymia develop a more severe form of bipolar illness.  Of course none of the cycles of bipolar disorder happen the same way for every person but it is important to understand the essential patterns of the different disorders.

Though this disorder has been studied by science for decades, much and little is known about the causes of bipolarism.  After hundreds of these medical studies, the scientific community seems to find a new link in the chains of bipolarism every year yet nothing comprehensive to connect them all.  The leading horse seems to be genetic theory.  From epidemiological and twin studies, the generally accepted theory is that a specific number of genes in combination with environmental factors are responsible for the disorder (Hunter 2004). Even with this tentative agreement on the theory of inheritance, the landscape remains murky and the genetic information elusive.  Many of these studies may contribute some new light, but most are quite speculative and end with “inconclusive results,” or requirements for “further study.”  As many do, if one surveyed the internet for comprehensive alternative theories on the causes of bipolarism they would find just as many notions with just as many flaws and “inconclusive results.”  These statements are not to diminish the efforts or work of those studying this disorder but to caution the practitioner against over simplification or grandiosity when thinking about bipolarism.  The answers seem to lie where they usually do – somewhere in the middle and all over.

My mother, Joanne Susan Geldner, was diagnosed with the classic Manic Depressive Disorder in 1975 after a complete mental break and institutionalization at age 30.  She had been in and out of institutions, received electric shock and had an over all unstable emotional life

since the age of 14.  In most ways she displayed classic symptoms of the disorder: wild visions of religious grandeur, psychotic episodes where she would wail and sing at the top of her voice, and times when she couldn’t be restrained unless straightjacketed. When she started having difficulties at age 14 the field of psychiatry had yet to embrace bipolarism like it has today and it took more than 15 years for her to get a diagnosis and a stabilizing drug regime that she would be on for the rest of her life.  In every sense of the word, my mother’s diagnosis and subsequent drug therapy literally saved her life and saved her from permanent institutionalization.  Unfortunately, this is often a typical scenario for many folks diagnosed with bipolar disorder.  Many may suffer years of mental distress or fluctuating mood cycles before some major episode catapults them into the world of psychiatry, a diagnosis and drug therapy. What I have experienced with those in my community who fall into this path is that their recovery tends to mimic the cyclical nature of their emotional states.  After a major episode, the drugs tend to stabilize and bring short-term relief for the bipolar person.  Then, since bipolar people are usually under the sole care of a psychiatrist and for many reasons often do not or can not seek out additional therapies to provide a holistic sense of health, the drug therapy tends to negatively affect their lives.  This picture can play out in many ways, but a frequent result is that the negative affects of the drugs will lead to such a serious decrease in quality of life that they can see the only way out as quitting the meds “cold turkey.”  Unfortunately, they are usually doing this without the guidance of a holistic practitioner or therapeutic counselor to help mitigate the problems that can arise, and after while can end up having another serious episode that lands them back where they started.

This cycling of relapses can be largely helped or altogether eliminated through the adjunct use of the holistic therapies of herbal practitioners.  Holistic practitioners take into account the whole person and their entire life when working with bipolar clients.  Since herbal clinicians do not diagnosis bipolarism, as it is both illegal and unethical to do so, they are freed to look at the larger picture of health for their clients and help to mitigate the negative affects of any drugs they may be taking. Many areas that a practitioner will address for any of their clients, such as chronic stress, diet and lifestyle will also be important to their bipolar clients.

Examining and understanding the impact of stress on hormone balance is extremely important in helping the bipolar client. Strong evidence links episodes of extreme stress to bipolar depressive onset and relapse, and to a lesser extent manic onset and relapse (Hunter 2004). The Sympathetic Nervous System (flight or fight response) is our involuntary nervous system.  We are not consciously in control of our heartbeat or our hormonal cascades; they operate involuntarily in response to our stress lives.  The Parasympathetic Nervous System (PNS) is like its subtle sibling, controlling our rest and relaxation/digest responses. The SNS releases adrenaline and cortisol into the bloodstream and the role of the PNS is to counterbalance these effects by calming the systems – slowing heart rate and breathing, calming the emotions and restoring spent energy.  Ideally, most of our time would be spent under the calming influence of the PNS with only occasional but essential stimulation of the SNS.  However, due to the chronic stress levels of the modern world, many people have over active SNS response and underactive PNS response.  Since the parasympathetic nervous system is responsible for alertness, cognitive processes, attention, emotional regulation and stress response it is no wonder that many mood disorders and cognition disorders are associated with a depressed PNS.  In fact, psychotropic medications used to treat mood disorders may lessen the sympathetic nervous system response but they have not been shown to strengthen the activity of the PNS and may dull cognition, blunt emotions, and interfere with mental functioning (Brown et al 2009).

Stress is managed by two different systems in the body:  the hypothalamic-pituitary-adrenal axis (HPA) and the sympathoadrenal system (SAS).  These two systems involve communication between the Sympathetic Nervous System and the endocrine system.  After a stressful event, the nervous system reacts and neurons will activate the HPA axis and the SAS.  If a stressor stimulates the hypothalamus it activates a cascade of stress-response hormones.  Under the influence of these hormones, the SAS interfaces with the sympathetic nervous system to create the flight-or-fight stress response in the body.  These reactions enact various changes, which cause the body to adapt and try to reestablish homeostasis.  This response usually elevates the heartrate while narrowing certain blood vessels so that more blood is sent to the brain, the lungs, and the muscoskeletal system while restricting blood and therefore functioning to the appendages, reproductive system, and digestive system. (Winston 2007).

There are many hormones involved in the stress response: cortisol, adrenaline, noradrenaline, DHEA, adrenocorticotropic hormone (ACTH) and aldosterone to name a few.  Three that have a large long-term impact on adaptive response are cortisol, adrenaline and nor adrenaline.  Cortisol, which is essential to metabolism, is released from the adrenal cortex (“outside”) in times of stress and is the most potent of the glucocorticoids.  When cortisol is released it causes a breakdown of muscle protein to be synthesized by the liver into glucose for brain function.  Under stress, this system increases glucose availability for the brain in the bloodstream by flooding it with this synthesized glucose and by reducing the uptake of glucose in other tissues for energy.  Cortisol also leads to an increase in blood triglycerides for muscle use.  It also regulates blood pressure and cardiovascular activity and as a steroid it aids in the inflammatory response.  However, too much chronic cortisol can adversely affect the immune system by suppressing its response.  Symptoms of elevated cortisol include anxiety, hypertension, sex hormone imbalance, insulin resistance (Type II diabetes), obesity, osteoporosis, insomnia, and polycystic ovarian syndrome.  Too little cortisol can cause symptoms of depression, chronic fatigue, hypotension, insomnia, PMS, infertility, impotence, and fibromyalgia (Winston 2007).

Adrenaline and noradrenaline are produced by the adrenal medulla (“middle”) and affect the sympathoadrenal system.  These are the “fight or flight” hormones and though normally present in the bloodstream in small amounts are secreted in larger amounts during stress response.  They stimulate the heart, blood flow to muscles and the brain, constrict blood flow to small blood vessels (i.e. in the appendages), raise blood pressure, increase blood glucose and impact nerve responses in the autonomic nervous system.  This impact on the nervous system can lead to a low functioning or damaged nervous system and symptoms of mood disorder.

According to Mark Hyman author of, the UltraMind Solution the following is a researched list of the effects of chronic stress (heightened SNS response/dampened PNS response/increased cortisol and adrenaline):

• Increases inflammation and inflammatory cytokines, which have all been linked to depression, bipolar disease, autism, schizophrenia, and Alzheimer’s.
• Reduces the natural relaxation and anti-inflammatory calming neurotransmitter called acetylcholine.
• Increases anxiety and depression.
• Damages the hippocampus, leading to memory loss and mood disorders.
• Increases the activation of NMDA receptors leading to brain cell death.
• Reduces serotonin levels.
• Lowers growth hormones.
• Reduces slow wave sleep.
• Reduces social interactions and sexual receptivity.
• Increases abdominal fat and insulin resistance (Type II diabetes)
• Interferes with thyroid function.
• Leads to the death of mitochondria and loss of energy production.
• Raises triglycerides and LDL while lowering HDL cholesterol.
• Increases stickiness of blood leading to clots (heart attack and stroke).
• Loss of muscle.

One of the most important things to address with a bipolar client is their own stress response and how it affects their hormone balance. Fortunately, herbal medicine is quite adept at helping the body balance these systems.  Adaptogens and tonics will be of utmost importance in any bipolar formula.  Adaptagens work by stimulating the body’s non-specific stress response through the HPA axis and SAS.  They help regulate the function of the central nervous system, endocrine secretions, and cardiovascular system, promote immune function and have an affect on stress response.  Since adaptogens tend to regulate the use of cortisol in the body they are great at reducing the negative affects of excess cortisol in bipolar people and helping to return the hormone levels to a more balanced place (Winston 2007).  Eleuthero Siberian Ginseng is an excellent choice for the bipolar client.  It is an adaptogen and a tonic that directly affects the hypothalamus and adrenals, addressing the hormonal imbalances at the very top of the cascade.  This works to help the body put itself back in line. It can help on a cardiovascular level by lowering LDL cholesterol and blood triglycerides while relaxing the arteries.  As spirit medicine, Eleuthero can melt one out of one’s mind or psyche and back into their body.  For a bipolar person who may feel trapped by their thoughts this can be especially helpful.  Holy Basil is another great adaptogen for this formula.  It reduces the stress hormone levels in the body, reduces blood sugar levels and helps to regulate blood pressure which all can be problems for chronically stressed bipolar people. In Ayurvedic medicine it is used to help clear mental fog (often a negative affect of bipolar drugs).  It is generally an uplifting herb, sweetly lifting the spirits without stimulating.  There are many useful adaptogens to help regulate the stress response but one that has been used for thousands of years is licorice.  This is an important herb in Traditional Chinese Medicine and is considered a balancer of the Five Organ Systems and has a synergistic affect on the other herbs in formula.  Licorice has a regulating affect on the HPA axis and specifically on cortisol levels.  It helps support and rebuild deficient adrenals and has hepatoprotective properties.  In large doses for long periods of time it can raise blood pressure and leach potassium so it is important to use in small amounts in formula and with caution for anyone who has hypertension.  Make sure that their diet is also including adequate amounts of potassium.   As a pre-cursor to steroids, it is also contraindicated with steroid use, like, Prednisone.  Other adaptogens may be appropriate in treatment, but with bipolar clients always be cautious about any herb that may have stimulating or antidepressant affects.  Rhodiola and St. John’s Wort, while excellent herbs for other forms of anxiety and depression, are both generally contraindicated for bipolarism because they run the risk of stimulation that can trigger a manic episode. Bipolar people are often very sensitive in general and do not need high doses of herbs as it can be harmful. With any herbal formula for bipolar clients you want to use low doses, tonifying or nourishing herbs, and go slowly and monitoring well. This way you can formulate with confidence and clarity for the best results for your client.

Another arm of treatment is including nervines to strengthen the parasympathetic response, promoting relaxation and reducing sympathetic system dominance.  Nervines, especially nourishing ones will help the CNS return to balance.  Skullcap is an excellent nervine for calming the SNS and for people who are very sensitive to stress.  It brings about a sense of calm and clarity without sedating. For those who have a difficult time shutting off their brains this can be extremely helpful.  The myelin sheath is extremely important in the regulation of neural firings in the nervous system. It has been hypothesized that irregular firings may be linked to states of mania and too rapid of firings linked to depressive states.  Wild Oats works directly on nourishing and building the myelin sheath and may have a direct affect on regulating these firings.  It is a sweet and gentle nervine that is helpful in a constitutional formula or in an acute attack formula or as a simple. Central nervous system stimulation can also affect the circulatory system with stimulation or agitation and the nervine Passion Flower can have a dual affect.  It relieves anxiety and restlessness and has a slight sedative property while also calming to circulatory excitation that is CNS influenced.  For cardiovascular toning, soothing and to lift heart energy, it is best combined with Hawthorne Berry.

While herbs will be invaluable in supporting a bipolar person, a more comprehensive evaluation of their diet will be essential. Evidence links many brain disorders, like bipolarism, to mitochondrial injury from oxidative stress, which can be triggered by poor diet and nutrient deficiencies, toxins, infections, allergens, hormonal imbalances, altered gut function and stress (Hyman 2009). Often allopathic therapies like mood stabilizers Depakote and lithium increase oxidative potential in bipolar people (Brown et al 2009). In evaluating this picture, blood work results can be an indispensable tool for the clinician.  It may be helpful for the client to keep a food diary, and a food and mood chart, writing down everything they eat and drink for at least a week to get a more complete picture of what their diet is really like and how it may trigger certain moods. Taking these results and a thorough health history, we can look at bipolarism and other brain/brain chemical imbalances from the vision of the whole person.  Here we can see how important diet changes may be to creating holistic wellness for that person.

Some of the most important vitamins and nutrients for mental health are those involved in the healthy functioning of nerve cells.  Depletions of these are most likely due to poor nutrition, or malabsorption from a poorly functioning digestive system (genetic deficiencies like missing enzymes, functional or structural dysfunction, “leaky gut”, Chrones Disease, etc.). The B vitamins, especially folate, are crucially important for nerve health and mood stabilization.  Dietary and supplemental folate/folic acid has to be converted into the useful form of L-methyltetrahydrofolate.  Either the reduced conversion or lack of folate in the diet can cause an increased level of homocysteine.  Increased levels homocysteine have been linked to increased cardiovascular risks that may develop as inflammation and elevated blood pressure.  Higher levels of inflammation can be a product of stress response or can trigger low-level chronic stress, which has been associated with chronic disease, circulatory issues, chronic pain and other disease symptoms.  Ultimately, the reduction of folate along with increase of homocysteine may contribute to depression and poor response to antidepressant medication.  Common causes of reduced folate levels include chronic disorder, diabetes, cancer, smoking, alcohol use, poor diet, and medications such as mood stabilizers, L-dopa, statin drugs, oral antibiotic drugs, and chemo drugs. (Brown et al 2009).  Since most bipolar clients are on at least one mood stabilizing drug, which alone is folate depleting, it may be necessary to supplement with a folate.  In addition, improving nutritional folate is essential. Vegetables, especially asparagus and dark leafy greens, and fruits like oranges, strawberries, and melons are excellent sources of folate. Meat, beans, liver, eggs, and sunflower seeds are also good sources. Since all B vitamins are very instable and susceptible to heat it may be better to eat raw fruits and lightly cooked or steamed vegetables as often as possible to preserve as many of the vitamins as possible (Pennington 2005).

Fat is a vital nutrient for bipolar health and specifically Omega-3 fatty acids.  Omega-3 fatty acids are essential to cell membrane construction and function.  They help provide the fluidity and flexibility of our membranes.  This impacts membrane proteins (enzymes, receptors, ion channels) that are intrinsically important in healthy neural transmission functioning. We need quality membranes for a healthy brain and a healthy nervous system.  Most cellular reactions require a flexible membrane to affect cellular metabolism, function and transmission.  If our membranes are not flexible or are damaged, there may be problems with functioning at all system levels but especially on a neural, brain chemistry level.  In a number of studies, bipolar participants who were supplemented with Omega-3 have shown significant improvement of membrane flexibility.  It has also been linked to lower lifetime prevalence of bipolar disorder, especially bipolar II and relapse rates (most participants are also on mood stabilizers).  For bipolar I clients, it has been shown to decrease depression.  For treating depression in bipolar clients doses of 1-2 grams/day of mixed Omega-3 fatty acids (EPA and DHA) have reduced symptoms but for clients with mixed symptoms of mania and depression or rapid cycling a higher dose is needed.  In Herbs, Nutrients and Yoga in Mental Health Care, Drs Brown recommend 8-20 grams/day of Omega-3 for these clients while acknowledging that most clients can only tolerate limits of 6g/day because of the digestive discomfort.  Omega 3 treatment is considered low-risk and can be appropriate for children, pregnant women and during breast feeding.

When choosing Omega-3 oil, is it important to select bioavailable oil from quality sources. Traditionally, EPA and DHA were nutritionally obtained through sources of fatty fish (salmon, trout, mackerel, herring, sardines, tuna, anchovies, etc.).  However, due to poor fish farming practices, environmental poisoning of the ocean, and mercury or PCB contamination, we are left with very few viable, safe, and ecological fish options. There are vegetable sources of Omega-3 oil like flax, walnut, primrose, and borage oil, which contain alphalinoleic acid (ALA).  Your body has to convert the ALA to Omega-3’s and this conversion is usually quite inefficient and varies greatly among individuals. There are many high quality, tested Artic Sea fish and cod liver oil supplements that have little to no mercury and PCB contamination, and this may be the most viable option.

Since there is an increase in oxidation in bipolar people, vitamin C is important to include in the diet or supplementation.  It is a strong antioxidant, protecting cell membrane function, increasing immune function, detoxing heavy metals, and improving stress response. Vitamin C levels are highest in the brain and adrenals, and psychiatric patients are often so low in vitamin C to approach scurvy levels.  There is continued research illustrating that adequate or higher levels of vitamin C has a supportive effect on bipolar healing. Because it is believed to occupy the same dopamine receptor sites as the pharmaceutical antipsychotics, it may be useful as an anti-psychotic/anti-mania agent.  There is some evidence that it may be useful as a main or sole treatment for bipolar mania but the doses have to be so high (at least 10grams/day) to be digestively cumbersome and incur absorption issues. But it may be helpful at slightly higher than normal supplement levels in conjunction with traditional treatments (Edelman 2001).  Dietary sources of antioxidants include bioflavonoid like the dark berries and also beans and artichokes.

Of course, building mitochondria through supplementation can only take a client so far.  If the causes of oxidative stress are not removed, these neuroprotective agents will not be useful as protectors but simply as minimizers.  Since clients will have personal stress triggers that bring on bipolar episodes and they must be able to recognize these triggers and begin to minimize their impact.  One way is to map out their moods and keep a record of the changes.  This provides a routine for the bipolar person and is extremely important to grounding them on a daily basis.  Often their shifting mood cycles will follow certain patterns and using tools like a Mood Chart will help them to recognize this pattern, predict stressors and strategize to minimize or diffuse them.  For example, they may drink a cup of coffee everyday and notice that around that same time their mood is extremely elevated, agitated and “high”. Many bipolar people feel that they are at the mercy of their emotions and can feel quite powerless in the face of extreme mood swings.  Having them keep track of their own moods, the stresses, foods, menstrual cycles and drugs that affect those moods, will help them have a more appropriate relationship to their emotions and give them more awareness and a tool to have more power over for moods.

Finding ways to regulate the parasympathetic nervous system is another important strategy.  The PNS main pathways are through the right and left vagus nerves.  The vagus nerves innervate the throat, heart, lungs, GI tract, liver, pancreas, genitals and blood vessels.  They carry messages from the body up to the brainstem and vice versa.  From the brainstem, the pathways ascend to the limbic system, thalamus, and cerebral cortex, impacting how we experience ourselves, our emotions and our state of consciousness (Brown 2009).  Increased vagus nerve stimulation leads to increases in PNS response.  One could have a pace maker implanted that stimulates the vagus nerve every few seconds but it would be much safer, cheaper, more realistic to be able to learn to do that ourselves.  Since the PNS is mostly involuntary we have a limited amount of control over the reflexes under its domain.  While breathing is fairly involuntary – we all breathe in our unconscious sleep – you can have some control over your breathing: the depth, the quality, the timing.  By doing some simple exercises one could begin to control the vagus nerve and therefore stimulate the PNS and reduce stress response.  Deep breathing practices expand the diaphragm, which stimulates the vagus nerve and is part of the relaxation response, which is necessary for the body and brain to heal, repair and renew (Brown 2009).  Deep breathing alone may not be able to bring a bipolar person down from a severe manic episode; it is one more strategy in combating the heightened stress response and helping a bipolar person strengthen their overall health.

It is important to have things that a bipolar client can do for themselves to take control of their health like diet, relaxation practices and lifestyle choices but having further support for this journey of emotional wholeness and balance is essential for the bipolar client.  A psychiatrist who only prescribes pharmaceuticals once every few months does not a support system make.  Recommending that they find a number of qualified professionals to support them like herbalists, nutritionists, a therapist or spiritual guide and any other practitioners they will need is invaluable to help them get a structured support network together outside of family and friends.  Having a round table of the practitioners working in communication and each other an efficient and effective form of support. This roundtable will be better equipped to track the client’s progress and hold them accountable to their healing plans. If the bipolar person cannot afford or doesn’t want to see that many different practitioners, a licensed therapist may be the most invaluable help they can get.  These professionals can work with them to unravel the core issues and are trained on dealing with and recognizing the mood cycles of bipolar people.  Since much of what disrupts a bipolar persons life is about the mind and emotions, they are often not aware of their bodies though their bodies are very impacted by their emotional cycles.  It may be helpful to them to seek out a somatic therapist, one who uses body-oriented approaches to counseling and psychotherapy. This therapeutic method uses developmental and psychodynamic approaches and addresses the crucial role of the body in the structure and process of the psyche (http://www.somaticpsychotherapycenter.org/). This form of therapy along with other body oriented modalities, like yoga, Feldenkries, or the Rosen Method may be very helpful to your bipolar client.

Even with these herbal, nutrition and therapeutic supports in place the bipolar client may find pharmaceuticals helpful or essential.  Usually after a psychiatric diagnosis, the client will be prescribed psychopharmaceuticals depending on the emotional state or needs of the client.  Whatever the presenting issue is, it will be addressed first with either antidepressants or antipsychotics.   Most commonly prescribed anti-depressants are SSRI’S (Selective Serotonin Reuptake Inhibitors) which block serotonin from being reabsorbed into the cells and allow for a higher amount of available serotonin in the blood that can alter mood.  If depression is the dominant issue and a maintenance antidepressant is needed, it’s usually given in low doses to ensure that it is tolerated. Antidepressants may cause some people with bipolar disorder to shift into a manic episode and because of this risk anti-depressant use, both pharmaceutical and herbal, should be monitored closely.  Antipsychotics work on changing the levels of neurotransmitters in the brain.  Typical antipsychotics affect dopamine transmission while atypical antipsychotics can affect dopamine and other neurotransmitters. Changes in neurotransmitter levels directly affect the transmission of nerve impulses from the brain. This dopamine blockage alters the pleasure signals and in essence curbs the euphoria and mania that is often present for bipolar people.  These types of medications are usually first line defense during serious bipolar episodes and may be used alone or in combination with other mood stabilizers in bipolar mania (http://www.webmd.com).

Mood stabilizers generally enter the picture after a more serious episode has been addressed and are used for mood maintenance and to prevent relapse. Though lithium salts are most often prescribed for mood stabilization, many of the mood stabilizing drugs are also anticonvulsants. These work by calming hyperactivity in the brain in various ways. These are most commonly used in seizure related disorders like epilepsy. Anticonvulsants were first used to treat bipolar disorder when it was noticed that epilepsy patients taking them had improved mood.  They are often prescribed for people who have rapid cycling (http://www.webmd.com).

Lithium is one of the most common drugs for bipolar disorder. It is a naturally occurring metallic salt and has been used in medical practice for about 150 years. Lithium salts were first used to treat gout and its mood stabilizing affects were first utilized in the late 1800’s.  The way lithium works is not entirely clear, but it is probably due to its effects on other electrolytes such as sodium, potassium, magnesium, and calcium. Because it is a salt, it is important that patients have normal kidneys and thyroid if they are to take Lithium and have regular blood lithium monitoring to avoid toxicity (Raber 2010).  One of the most common and serious negative affects of taking lithium long term is kidney issue.  Due to the large amounts of lithium salts that clients generally take (600-2,400mg/day) the kidneys can easily become over loaded and have difficulty retaining water and sodium thus altering the sodium potassium balance. Often clients can combine lithium with another mood stabilizer to reduce the amount of lithium needed and reduce the affect to the kidneys.  It is extremely important for those on lithium to drink adequate amounts of water -  more than eight glasses a day- and have their blood lithium levels monitored. At least 30% of those taking lithium experience excessive thirst and urination. Considering a lower salt (but not no salt) diet may lessen the kidney load as well.  This is an area where dandelion leaf is recommended.  It is a diuretic, which is a contraindication for lithium use, and one study says that it may enhance other negative affects of lithium (http://www.umm.edu).  However, an herbal dosage in formula would be vastly lower than those used in experimental or clinical studies and should be considered generally safe in lower doses. It does not leach potassium further harming the kidneys like most diuretics and when used under the care of an herbal clinician who will monitor for any negative affects, it supports kidney function safely and effectively.  While the Nettle leaf, a vitamin and mineral rich green leafy plant, is a stronger diuretic the medicine of Nettle Seeds is a much safer and minimally diuretic specific for kidney healing.  It would be a great choice for building kidney strength and preventing nephron damage. Pam Fischer, director of the Ohlone Herbal Center and Clinic in Berkeley, California suggests the use of adaptogenic kidney tonic Guduchi.  She says that though it is very mildly diuretic as most kidney tonics are, it actually moistens the kidneys, drawing water to them instead of flushing them. Caffeine, as another mild diuretic, in long-term chronic use is known to exacerbate kidney problems. Avoiding or eliminating caffeine in coffee or soda, would not only help minimize simulating a manic episode but also help to reduce its impact on the kidneys.

A bipolar person should also be aware of their thyroid health. Studies have shown that there is a clear connection between hypothyroidism, especially autoimmune hypothyroidism and incidence of bipolarism, especially cyclothymic bipolarism.  There is also evidence that those bipolar people with a lower functioning thyroid even if their levels appear in the “normal range” are less likely to improve than those with higher levels of thyroid (Phelps 2009). Whether due to stress related disruption of the endocrine system taking its toll on the thyroid or the affects of lithium, this tiny organ will need special attention for the bipolar client.  Again, working with the endocrine system as a whole (the hypothalamus, pituitary and adrenals) with adaptogens will be the most important strategy.  Supporting the thyroid directly will also be necessary.  Fucus is a specific for low functioning thyroid and if there is a problem with low iodine, any seaweeds like, kombu or kelp will help increase iodine.  Coleus forsckoholii, an Ayurvedic herb, has traditionally been used for cardiovascular health and blood pressure regulation and recently has been shown to stimulate thyroid function.  A common dosage is 50-100mg TID of a 10-20% standardized extract.  It may have some antidepressant affects and so should be monitored with bipolar clients.   Certain other herbs known to help build the thyroid like Red Ginseng, Maca, or Gotu Kola may be too stimulating for bipolar clients and if added to a formula should be used with extreme caution.

Though lithium’s primary negative affects are on the kidneys and thyroid it also affects the liver, especially when used with other drugs.  The liver is our main metabolizing and detoxification organ and pharmaceuticals, especially at the bipolar dosages, will tax or damage the liver. They can also cause symptoms of liver deficiency like dry skin, eczema and allergies.  Hepatoprotectives like Oregon Grape Root, Yellow Dock and Milk Thistle are important additions for supporting the liver to take on the extra load and prevent liver damage.  In fact, Herbalist Matthew Wood testifies to using low dose Dandelion root, another liver herb, to help relieve the symptoms of bipolarism (Wood 2008). Reducing or eliminating other dietary liver toxins like alcohol is another way to reduce liver impact.  Many of the liver supportive herbs are also alterative and can help stimulate the body’s natural metabolism to remove toxins in the system.  Most alteratives like burdock, nettles, alfalfa, red clover and red raspberry leaf are gentle and safe tonics that are often best combined in a therapeutic tea that is drunk daily.  With the highly green nutritive herbs like nettles and alfalfa one should make sure to monitor for any diuretic affects while taking lithium.  If a client’s urination amount is regularly excessive for their liquid intake readjust the dosage or frequency or consider using other herbs.

In addition to a circle of professional support and assistance, the bipolar client will need other support in place for whatever therapies they are seeking out.  It is important for them to involve family and friends in an organized support network.  Often the bipolar person suffers alone or is reliant on one person like a partner for all their support.  This is often not sustainable for anyone in this scenario and can lead not only to further difficulties for the bipolar person but to alienating any existing support. Just like any health related matter, the bipolar client is in charge of their healing process.  There should be a clearly articulated directive from the bipolar person for their healing plan: strategies for daily mental health balance and support, what the bipolar person is doing on their own, and what they will need from their support system to help achieve this.  Developing a written plan for crisis (manic or depressive) is essential and making sure that the group has discussed and is clear about what the bipolar loved one does and does not want done in these situations (i.e. hospitalization is never ok or call my mother if I’m having a manic episode, etc) is crucial. In many friend and family circles of bipolar clients, there is a tendency for the support systems to be disorganized, take on too much, and to place the bipolar persons emotional needs above their own.  The support system should seek out education on bipolarism from qualified sources so they can begin to understand what is happening to their loved one.  Often for bipolar people, it is a daily struggle to simply remain functional in their emotional lives and many may need a lot of support to achieve this goal.  However, adult bipolar clients are the subjects of this paper and they are capable of making their own choices and taking responsibility for their lives.  It is not helpful to a bipolar person to not be held accountable for their actions or decisions.  When the support system focuses entirely on the supported person and has no plan for making sure that they are also getting their needs met it can lead to stress, anxiety or depression and also burn out, anger, blame and abandonment. They might think their problems are minor in comparison to what the bipolar loved one is coping with, but that doesn’t mean they are any less deserving of help and comfort.  It’s important for loved ones to build their own support system of people who will listen and be concerned about their well-being, including friends, relatives, and other professional healers.

Children are affected by a family member’s bipolar disorder or depression, even if they don’t understand exactly what is happening. They learn from observation very quickly when they are young and if they are not included in the discussion and support network for a bipolar family member they will devise their own coping skills that may have negative impacts on their development. It’s important to spend time with children, explain the situation and encourage them to share their feelings and questions. Talk to children at a level they can understand. Younger children might be satisfied with “Mommy (or other relative) doesn’t feel good right now but is getting help to feel better.” Older children may be given educational materials and encouraged to learn about bipolar disorder or depression and how they can help their family member. Reassure children that there will be someone to take care of them and that they are loved and prioritized by their family.  Parents should always apologize to children for any hurtful things they may have said or done during an episode of mania or depression and allow their children any reactions. Let children know their parent is working to keep these things from happening again. Appropriate child therapy models like, writing therapy, art therapy, play therapy and movement-based therapies may be helpful but it is important to emphasize that there is nothing wrong with them and that their family members disorder is not their fault.

A well-supported and organized circle of friends and family will enable the bipolar person to feel clearly supported and reduce the amount of stress and confusion for the whole group.  To help this process, it may be necessary for clinicians to see bipolar clients together with members of their support system or to see the support people separately. It is also appropriate to refer the loved ones to existing therapeutic support groups for friends and relatives of bipolar people. In helping the loved ones, adaptogens, nervines and adrenal tonics are useful because they will undoubtedly be undergoing heightened stress. Having loved ones keep a Mood Chart too may be helpful for their own tracking of emotional highs and lows and the situations that trigger them. Flower essence therapy may be one of the most important supportive measures that clinicians can utilize.  They are safe and have no interactions with any drugs or herbs and can be added to a family’s water, meals or spritzed into the air.  Many of the same flower essences that will be helpful for the bipolar client with also be helpful for their loved ones.  Using Self-Heal and Lotus Flower can start anyone off on the right foot with removing blocks that we put in the way of our own healing and instilling confidence in our own ability to heal.  Lotus also has a special affinity for bipolar people who can tend towards visionary or spiritual excess in that it can assist in learning the spiritual lessons of everyday life.  To ground in the path of healing Black Eyed Susan can help to accept that we need help and we need to heal.  Rock Rose can help both the supported and the supporters deal with the terror and panic of mental crises while Cherry Plum can be useful for the person who is displaying out of control or destructive behavior. To further protect against negativity on a psychic and psychological level and clear these poisoning affects from the body we look to Pennyroyal.  There are many essences for support in building and maintaining healthy boundaries, which can be extremely important for those supporting people with mental health issues.  Pink Yarrow enables us to maintain our self in all situations, helping those with a tendency to merge with other people or take on their issues to remember what is ours and what is theirs.  Essences of Rue or Ocotillo are the heavier hitters for psychic protection.  They are called on when we need to have major protection and act as psychic barbwire for our spirits.  The bipolar person may have difficulty trusting other people especially if they have been abused by the psychiatric industrial complex or been forced against their will into hospitalization.  Oregon Grape helps them to accept the love and good will of their support network and trust their intentions. Stress and exhaustion will play a huge part in all those involved in this work and many flower essences supply support and relief. For the supportive person who doesn’t know when to stop and pushes herself even when exhausted, Oak and Elm can be helpful.  Supportive people can often have an unbalanced need to care-take or serve others in need and Centaury can help bring balance.  Often since bipolar people are made reliant on psychiatrists and family members they can develop an over reliance on others advice.  Cerato aids them to make their own clear and confident decisions.  Simple lavender essence can be calming and rejuvenating when nervous tension leads to depletions and dandelion can help clear stress and anxiety that is held in the body and manifests as physical issues.  Of course, happiness, joy and fullness of life are important to any healing process.  Borage has been used to supply heart lightness and courage and optimism when facing difficulties.  Violet or Johnny Jump Ups provide springy, buyout joy and happiness while Mustard Flower can transform the gloom of depression into a balanced and contented happiness.  Lastly, for children helping them cope with a potentially dysfunctional family and the hurt is causes is a key affect of  Nettles flower essence.  These are but a few of the possibilities that you can call on from the flower essence repertoire and deep consultation with the individuals will reveal what specific needs they will have.

Whether due to over diagnosis or better diagnosis, an extreme rise in modern stress levels, environmental factors, dietary factors, genetic factors or any other reason, there is a consistent rise in the occurrence of bipolarism.  As an herbal clinician you will most likely see clients with this diagnosis and many of them will be seeking holistic help adjunct to their pharmaceutical therapies.  With the tools of the holistic Western herbalist  – in depth health and medical consultations, comprehensive constitutional and acute herbal formulas, diet, lifestyle, and supplementation evaluation and consultation, stress, mood and emotional evaluation, flower essences– combined with therapy and spiritual work, and a healthy and functioning support system, there is much to be offered the bipolar client.  These strategies combined can help to bring about a more full and secure sense of wellness for the bipolar person and hopefully lead to long lasting aid and support.

Footnotes: [1] Criteria for Major Depressive Episode (DSM-IV, p. 327) A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations. 1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g. appears tearful). Note: In children and adolescents, can be irritable mood. 2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others). 3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains. 4. Insomnia or hypersomnia nearly every day 5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).  6. Fatigue or loss of energy nearly every day.  7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).  8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) 9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.  Criteria for Manic Episode (DSM-IV, p. 332) A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary). B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree: 1.inflated self-esteem or grandiosity 2. decreased need for sleep (e.g., feels rested after only 3 hours of sleep) 3. more talkative than usual or pressure to keep talking 4. flight of ideas or subjective experience that thoughts are racing 5. distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli) 6. increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation 7. excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments) C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism). E. The symptoms are not better accounted for by bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

Bibliography

Mood Chart

Mood Chart and Diary Instructions

In addition to being a member of our community, she was a loving wife, mother and grandmother. She is greatly loved and will be deeply missed.

Marion’s official death notice can be found here

We will keep you informed as we learn of memorial services.

The last two years have been a very exciting time for the Center. With a lot of thought and hard work, we have made some substantial changes.

Non-profit Status
In June of 2006, we began working on our transition to non-profit status. After many hours of paperwork and much waiting, we finally received our official non-profit status on June 9, 2009.

The Big Move
This June, we moved out of our cramped offices of the past 4 years into a beautiful space that will serve us well during the next part of our development. Our front windows look out onto the expansive lawn of Strawberry Park. Strawberry creek runs wild to the right of our door and the Berkeley Youth Alternatives garden are just steps away. We are busy this summer transforming our new space to meet our school and clinic needs.

Changes in the Program
Much has happened regarding the program. The school has expanded to include an 8 month, 3 days per week intensive course, which suits the needs of those students who cannot attend evening classes. Also, a San Francisco satellite 10 month program in Foundations of Herbalism offered for the last 2 years.

In addition, there have been big changes in the student clinic. Student clinic has extended its operation to be year round rather then 10 months. Our 400 hours of supervised training meets the professional requirement of the American Herbalist Guild (AGH). Our clinic sees close to 125 people a month, giving our students one of the best clinical herbal educations in the field. At the request of advanced students we have added a second year clinic program.

Herb Room
Tony Seifert now manages all our medicine making needs and we took on dispensary services for herb rooms at the Charlotte Maxwell Complimentary Clinics in Oakland and San Francisco. C.M.C.C. is a non-profit free clinic serving low income women with cancer.

We were approached by the Cavallo Point, Hotel and Spa in Sausalito for an employment opportunity for a graduate of our program. Katie Delwiche was hired and is now their resident herbalist. Our graduate Dixie Block was hired to work at the Harborside Clinic in Oakland. Our graduates Atava Garcia Swiecicki and Sharon Bargil, received professional status with the AHG.

Projects

There are a number of projects that we are currently involved in. Second year clinic student Tracey Brieger is working with East Bay Agency for Children (a social service agency) to help six preschoolers with severe behavior problems avoid the use of anti-psychotic medication using diet, herbs and exercise. Another clinic student Michelle Steinberg, will be spearheading an herbal wellness program at the Street Level Clinic in Oakland. Street Level is a day labor center for Spanish speaking immigrants. She will be developing a public service model for working with this population.

National Status
In October 2008, Pam Fischer, our executive director, was elected to serve on the National Board of Directors of the American Herbalist Guild.

It has been a very full last few years, but our vision is far from complete. A number of projects still await us including: a special training program for Midwives, Doulas and Herbalists to work with pregnancy; a Senior Health Advocacy program, working with a senior residence center in our neighborhood; networking with the Berkeley Youth Alternatives on teaching herbalism for gardening trade and the Urban Creek Foundation in planting the native medicines in our creek. Other projects include getting herb rooms into public service clinics and finding grant money to help support them. Our plan in 2011 is to begin a Marin satellite program.

Ohlone Herbal Center is the leader in the Western Herbal Movement in the Bay Area. Your support and contribution will help propel us forward. Herbalism is often overlooked as a model for health care in America. We believe we have something to contribute to the health care crisis at hand, offering affordable medicine that is both green, sustainable and free of pollution causing toxins. Any financial support you are able to give will help in the fulfillment of our dream.

Thank you for your generosity,
Pam Fischer, Executive Director on August 28, 2009

The Ohlone Herbal Center and its students are the heart of the San Francisco Bay Area herbal movement. Acting as an educational resource for medicinal herbs in our community, we are leaders and activists in bringing herbal medicine and knowledge to the people who need it. Be it through operation of our community clinic, supplying herbs to multiple other bay area free clinics or training herbal clinicians to work in them; we address our communities’ needs for health education. In addition, the Ohlone Center provides something most other schools don’t – we have an available Clinical Herbalists Group resource with a growing network of students and graduates and a unique referral system we make available to the public.

When starting an herbal training program, students are often concerned about the viable employment opportunities that await them. We are a community-based School on the cutting edge of the alternative health field. Our training and support networks offer everything needed to establish yourself as an herbalist. While much of the time studying at Ohlone is in the realm of the plants, not income, our program graduates are trained in starting their own private practice as well.  After graduation we continue to help our herbalists with referrals, business services, ongoing workshops and clinician support groups. We actively create opportunities for professional positions by helping our community care clinics expand into plant based medicine. In addition, Ohlone Center has shown leadership year over year in developing modes of complimentary practice that translate into additional career opportunities for our graduates. There are multiple directions graduates can take; private practice, working with medical practitioners in complementary care facilities, free clinics, medicine making and/or manufacturing, teaching, sales, or consulting to name a few. What the Ohlone Center provides is an exceptional education which allows and encourages graduates to use their own business savvy coupled with the support of the Center in finding their individual niche within their own communities in private practice, healing centers, or hospitals.

Medicinal herbalism is the longest uninterrupted practice of healing art on the earth. It is still used as the primary medicine of 75% of the world’s population. In other first world countries such as Germany, Japan and England, herb effectiveness is recognized and used as part of the health care delivery system. It is a sustainable, non-polluting renewable resource with some answers for our worsening health care crisis here in the US. The herbalist plays an important role in today’s health education and prevention. Herbalism is affordable and healing; the plants tone and invigorate dysfunctions returning the body to health.

This current crisis provides well trained herbalists with great opportunities to make a living providing health education and herbs for healing to their community without injuring the planet or joining the rat-race. There is great opportunity in crisis. We can’t know what students and practitioners will do with the knowledge they have gained or imagine all the wonderful innovative businesses they will set up.  But we can provide them with a solid network of herbal practitioners to call on for support and provide our unique referral service.

By Pam Fischer, Executive Director on August 9, 2009