Herbal Approaches to Alcohol Dependence: Evidence and Risks

Herbs and Helpers

Erik Hefti obtained his PharmD and Master’s degree in pharmaceutical science at the University at Buffalo. His research focus is pediatric pharmacogenomic factors impacting cancer chemotherapy. He is currently completing a PhD in pharmaceutical science at the University at Buffalo while practicing as a clinical pharmacist at Sisters of Charity Hospital, St. Joseph Campus in Buffalo, NY.

Alcohol dependence is a problem facing many in our society. Many factors influence the decision to seek help with alcohol dependence, but embarrassment and shame may lead some toward self-treatment.1 As with many other conditions, there are OTC herbal supplements that claim to be an effective treatment option. Three herbal supplements commonly seen as self-treatment options for alcohol dependency include St. John’s wort (Hypericum perforatum), Ashwagandha (Withania somnifera), and Kudzu (Pueraria lobata). Although many pharmacists are familiar with these herbal supplements to some degree, that understanding is often related to potential adverse effects and drug–drug interactions. Their use in treating alcohol dependence and the associated literature is not as well known. The goal of this brief article is to review what is known about using these supplements for treating alcohol dependence.

1. St. John’s wort: Most pharmacists are familiar with this herbal supplement and its (unapproved) use for depression. Some may not be aware that it can be a component in “detox” supplements and may be used by some to self-treat alcohol dependence. There have been some scientific studies investigating the use of St. John’s wort to treat alcohol addiction in rat models that showed some promise. The use of St. John’s wort reduced alcohol intake in rats, but there’s scant evidence that St. John’s wort can have a similar impact in human subjects.2,3 Currently, the known risks of taking St. John’s wort far outweigh any potential clinical benefit.

2. Ashwagandha: This herbal supplement is used in traditional Ayurvedic medicine and has been used by some to overcome alcohol withdrawal or cravings. Many claim that it has anxiolytic effects that helps prevent alcohol cravings. Rat studies showed that Ashwagandha lowered anxiety associated with alcohol withdrawal, but its impact on seizure threshold hasn’t been thoroughly established.4,5 There’s currently no convincing evidence in human subjects that supports its use in treating alcohol dependency.

3. Kudzu: Kudzu is often advertised as a way for drinkers to cut back on alcohol. It’s thought to act as an “aversion” agent, inhibiting the clearance of acetaldehyde (a toxic metabolic byproduct of alcohol), which may decrease alcohol cravings. This is similar to how the approved drug Antabuse (disulfiram) works in the body.6 Modest reductions in alcohol intake were noted in a single study of young human subjects taking kudzu extract.7 Other studies didn’t mirror these results in humans subjects.8 Kudzu hasn’t yet shown a clear benefit to drinkers trying to reduce alcohol consumption.

As with many other OTC herbal supplements, there’s little convincing evidence that the aforementioned supplements are clinically effective treatments of alcohol dependency. There have been some scientific studies conducted, but a majority involve animal models and show modest findings that rarely translate into conclusive human trials. The primary danger of these supplements in those with alcohol dependency is not necessarily knowing the drug–drug interaction potential or side effects. The real danger may be the possible delay in seeking professional help for the dependence. If asked about herbal treatments for a drinking problem, it is advisable to recommend speaking with a professional rather than self-treatment with over-the-counter supplements.

References
1. Dearing RL, Stuewig J, Tangney JP. On the importance of distinguishing shame from guilt: Relations to problematic alcohol and drug use. Addict Behav. 2005;30(7):1392-1404.
2. Rezvani AH, Overstreet D, Yang Y, Clark E. Attenuation of alcohol intake by extract of Hypericum perforatum (St John’s wort) in two different strains of alcohol-preferring rats. Alcohol and Alcoholism. 1999;34(5):699-705.
3. De Vry J, Maurel S, Schreiber R, De Beun R, Jentzsch K. Comparison of hypericum extracts with imipramine and fluoxetine in animal models of depression and alcoholism. European Neuropsychopharmacology. 1999;9(6):461-468.
4. Ruby B, Benson MK, Kumar EP, Sudha S, Wilking JE. Evaluation of Ashwagandha in alcohol withdrawal syndrome. Asian Pacific Journal of Tropical Disease. 2012;2:S856-S860.
5. Mohan L, Rao U, Gopalakrishna H, Nair V. Evaluation of the anxiolytic activity of NR-ANX-C (a polyherbal formulation) in ethanol withdrawal-induced anxiety behavior in rats. Evid Based Complement Alternat Med. 2010;2011. pii: 327160. doi: 10.1155/2011/327160.
6. McGregor NR. Pueraria lobata (Kudzu root) hangover remedies and acetaldehyde-associated neoplasm risk. Alcohol. 2007;41(7):469-478.
7. Lukas SE, Penetar D, Su Z, et al. A standardized kudzu extract (NPI-031) reduces alcohol consumption in nontreatment-seeking male heavy drinkers. Psychopharmacology. 2013;226(1):65-73. doi: 10.1007/s00213-012-2884-9.
8. Shebek J, Rindone JP. A pilot study exploring the effect of kudzu root on the drinking habits of patients with chronic alcoholism. J Altern Complement Med. 2000;6(1):45-48.

Source: Pharmacy Times

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Turmeric based herbal supplement as effective as antidiabetic drug

Herbs and Helpers

Wed. Dec 7, 2016 (foodconsumer.org) — A new study suggests that a supplement made of Curcuma longa and Eugenia jambolana may be used to treat type 2 diabetes mellitus effectively.

The study led by Sadia Saleem Rao and Rahila Najam at University of Karachi in Karachi, Pakistan shows that the supplement treated type 2 diabetes mellitus as effectively as an antidiabetic drug called glibenclamide.

Curcuma longa is known as turmeric in which curcumin is the main active ingredient. Curcumin has been tested and found to be effective in preventing type 2 diabetes mellitus.

A study shows that taking curcumin in a dose of six grams per day for three months prevents pre-diabetes patients from developing diabetes mellitus in 100% patients.

Eugenia jambolana is another herbal medicine that has been tested in many studies for its efficacy in treating diabetes mellitus.

The supplement with Curcuma longa and Eugenia jambolana in a1 to 1 ratio seems to be already used in Pakastan traditionally to treat diabetes mellitus. The study has revealed evidence that this supplement could be indeed effective at managing diabetes mellitus.

For the study, alloxan induced diabetic rats were orally supplemented with this herbal supplement in a dose of 1082 mg per 70 kg twice a day for six weeks.

The study results show that the combinational herbal supplement significantly reduced both fasting and random plasma glucose levels with HbA1C lowered by 6% compared to the controls. The efficacy of this supplement is similar to that provided by glibenclamide. Glibenclamide is a drug commonly used to manage diabetes mellitus.
Turmeric is one of the hebral supplements anyone can use to prevent or treat many diseases including cancer and Alzheimer’s disease in addition to diabetes mellitus. This spice is amazingly safe to use. (David Liu)

Pak. J. Pharm. Sci., Vol.29, No.1, January 2016, pp.201-204

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Parkinson’s disease ‘may start in gut’

Herbs and Helpers

Scientists in California say they have transformed understanding of Parkinson’s disease.

Their animal experiments, published in the journal Cell, suggest the brain disorder may be caused by bacteria living in the gut.

The findings could eventually lead to new ways of treating the disease, such as drugs to kill gut bugs or probiotics.

Experts said the results opened an “exciting new avenue of study”.

In Parkinson’s disease the brain is progressively damaged, leading to patients experiencing a tremor and difficulty moving.

Researchers used mice genetically programmed to develop Parkinson’s as they produced very high levels of the protein alpha-synuclein, which is associated with damage in the brains of Parkinson’s patients.

But only those animals with bacteria in their stomachs developed symptoms. Sterile mice remained healthy.

Further tests showed transplanting bacteria from Parkinson’s patients to mice led to more symptoms than bacteria taken from healthy people.

Dr Timothy Sampson, one of the researchers at the California Institute of Technology, said: “This was the ‘eureka’ moment, the mice were genetically identical, the only difference was the presence or absence of gut microbiota.

“Now we were quite confident that gut bacteria regulate, and are even required for, the symptoms of Parkinson’s disease.”

‘Paradigm shift’

The scientists believe the bacteria are releasing chemicals that over-activate parts of the brain, leading to damage.

The bacteria can break down fibre into short-chain fatty acids. It is thought an imbalance in these chemicals triggers the immune cells in the brain to cause damage.

Immune cells in the brain – microglia – may be activated by bacteria in the gut
Dr Sarkis Mazmanian said: “We have discovered for the first time a biological link between the gut microbiome and Parkinson’s disease.

“More generally, this research reveals that a neurodegenerative disease may have its origins in the gut and not only in the brain as had been previously thought.

“The discovery that changes in the microbiome may be involved in Parkinson’s disease is a paradigm shift and opens entirely new possibilities for treating patients.”

Parkinson’s is currently incurable.

While the findings need to be confirmed in people, but the researchers hope that drugs that work in the digestive system or even probiotics may become new therapies for the disease.

The trillions of bacteria that live in the gut are hugely important to health, so wiping them out completely is not an option.

Dr Arthur Roach, from the charity Parkinson’s UK, said: “In recent years, evidence has been growing that Parkinson’s may begin in the gut, but the chain of events involved has so far remained a mystery.

“This work opens an exciting new avenue of study on the gut-brain connection in Parkinson’s.

“There are still many questions to answer, but we hope this will trigger more research that will ultimately revolutionise treatment options for Parkinson’s.”

Dr Patrick Lewis, from the University of Reading, said: “This study really does reinforce the idea that examining what goes on in the stomach of people with Parkinson’s could provide really important insights into what happens in disease, and potentially a new area of biology to target in trying to slow down or halt the changes in the brain.”

Source: BBC

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‘Exercise boosts men’s sperm count’

Herbs and Helpers

Doing at least half an hour of exercise three times a week may boost men’s sperm count, say scientists.

Men who took up running and stuck with it had more “healthy swimmers”, according to the research in the journal Reproduction.

The boost was only temporary, and began to wane within a month if the men stopped their treadmill training.

Experts say it is important to strike the right balance because too much exercise can harm sperm production.

Studies have shown that participation in competitive sports, like cycling, can lower sperm quality.

Sperm boosters

Keep your testicles cool – avoid tight underwear and hot baths

Avoid sexually transmitted infections

Stop smoking

Cut down on alcohol

Stay slim

Get some exercise, but not too much!

All of the 261 men enrolled in the recent trial were healthy and did not have any fertility problems as far as they could tell. They had normal sperm counts and healthy-looking sperm and led fairly sedentary lives.

The men were allocated to one of four programmes:

no exercise
three sessions a week of high intensity interval training (10 one-minute bursts of very fast running with a short recovery period between each bout)
three sessions a week of moderate exercise (30 minutes on a treadmill)
three sessions a week of intense exercise (about an hour on a treadmill)
Exercise training appeared to boost sperm quantity and quality, with moderate exercise coming top.

Men in all three exercise groups lost weight and saw improvements in their sperm test results compared with the men who did no exercise over the 24-week trial period.

The researchers say at least part of the benefit may come from shedding excess weight – all three exercise groups lost some body fat.

Experts already know obesity can lower a man’s fertility. A third of the men in each study group were overweight.

Fertility aid?

What is not clear is whether the boost from exercise translates to better fertility. That is something the researchers plan to explore in the lab by checking if training-induced changes affect the fertilising potential of sperm.

Lead researcher Behzad Hajizadeh Maleki said: “Our results show that doing exercise can be a simple, cheap and effective strategy for improving sperm quality in sedentary men.

“However, it’s important to acknowledge that the reason some men can’t have children isn’t just based on their sperm count. Male infertility problems can be complex and changing lifestyles might not solve these cases easily.”

Allan Pacey, professor of andrology at the University of Sheffield and spokesman for the British Fertility Society, said: “We have a very poor understanding of how physical exercise affects male fertility and sperm quality, but it is a question commonly asked by men wishing to improve their chances of having a child.”

He said there probably was a level of exercise that is optimum for male fertility, but recommended that men check with their GP before embarking on anything too strenuous.

UK guidelines recommend that adults do at least 150 minutes of moderate aerobic activity, such as cycling or fast walking, or 75 minutes of vigorous aerobic activity, such as running, every week.

Source: BBC

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