(CHINESE) HERB NEWS
Herbs in this issue:
Rhodiola (hong jing tian)
A Note From Dr. Leung
According to the most recent national survey published in 1998,1 40% of the respondents used some form of alternative health care, up from 34% reported in a well-publicized earlier study.2 The top 4 most frequently used alternatives to conventional medicine by respondents in the latest study were chiropractic (15.7%), lifestyle diet (8.0%), exercise/movement (7.2%), and relaxation (6.9%). Other also-prominent categories included massage, herbs, homeopathy, self-help groups, megavitamins, and art/music therapy. Conventional dietary supplements don’t belong to any of above, except perhaps the “lifestyle diet” category. These true, non-drug dietary supplements are consumed in relatively low doses for general health maintenance and disease prevention, not for treating any particular disease. However, if any of these nutrients is lacking in one’s diet, one will have health problems, which are often not immediately obvious whether they are pathogen or toxin induced, or caused by nutrient deficiency. These dietary supplements have been popular with Americans for several decades.
Dr. Leung is author of the Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics (Wiley-Interscience), which was published in 1980 and revised in 1996. He is also creator of PHYTOMED, a prototype computer database on Chinese herbal medicine developed under contract with the National Cancer Institute.
Nevertheless, sometimes they are also used in very high doses for self-medication, which then fall under the “megavitamins” category. Under the “herbs” category, we can count dietary supplements of botanical origin, which are most likely now being consumed for therapeutic purposes. Thus, among the 70% of U.S. adults estimated by a trade journal/newsletter to have taken supplements in 1999, the vast majority would have taken the best-selling herbal drugs such as mahuang, echinacea, valerian, kava kava, St. John’s wort, saw palmetto, and ginkgo biloba, etc. Is self-treatment with these so-called “dietary supplements” safe and beneficial? There are no simple answers. From a holistic or traditional Chinese medical point of view (or plain common sense), most therapeutic herbs should not be used daily for long periods of time. They are to be used only for a short time and to be discontinued after the specific problem is resolved or alleviated, otherwise they will disturb one’s body balance, weakening its defense (e.g., immune and/or hormonal system). The indiscriminate use of herbs to treat whatever ails one is no better than relying on drugs for the same purpose. Over the past several years, many Americans have started to switch from a drug-oriented culture to a “dietary supplement”-oriented one, believing it is a better choice. Thus, instead of taking a synthetic drug for one’s headache or stress, one is now taking an herbal drug labeled as a “dietary supplement.” Despite their natural origin, some of these “dietary supplements” are not totally safe and are in some instances no safer than synthetic drugs. And there is another problem. With synthetic drugs (OTC or prescription), we at least treat them as drugs, with certain amount of caution; and there is a lot of information (both good and bad) on them. With “supplements,” on the other hand, there is often little or no unbiased information on many of them besides marketing and advocacy literature, including results of quasi- “clinical trials.” Furthermore, since they are called “dietary supplements” under the same safe umbrella as vitamins and minerals that are generally considered as part of our food intake, we tend to lower our guard and assume a sense of false security. For example, normally, an American consumer wouldn’t think of taking even 3 or 4 times the recommended dose of an OTC drug such as aspirin or naturally derived prescription drugs like reserpine and digoxin, no matter how weak and casual the warning. But he/she may not think twice before taking 5 or 6 times the recommended dose of a “dietary supplement,” no matter how strong the warning on its label, which they sometimes don’t even pay heed. The reason is that a consumer often cannot tell a true herbal supplement (or food) from an herbal drug, because both are labeled as “dietary supplement.” Currently, there is a general misconception among the American public relating to things herbal or natural. Many people equate natural to safe. Thus, chemicals such as ephedrine, synephrine, catechin, epigallocatechin, huperzine A, and numerous others soon to be popularized, are consumed daily in large amounts. Daily consumption of such unnaturally large quantities of these chemicals, though natural, was never done in the course of human history. If not restricted, it’s just a matter of time before serious problems surface. There is such a strong self-interest among certain producers and marketers of “dietary supplements” to maintain the status quo that unbiased information about the herbal drugs they sell is not disseminated or publicized. The result is a general public that is being educated by the industry to believe that there is an “herbal supplement” for every ache and pain. Our American drug-oriented culture is now being switched to another form that uses herbal drugs, sanctioned as “dietary supplements.” Are these the kinds of “supplements” we should take?
I see nothing wrong with taking herbs (even occasionally a strong one) for one’s aches and pains, provided that unbiased information about them is readily available and one uses them in moderation. Thus, when an herb is used to treat an illness, no matter how it is called, it is a drug, and for safety’s sake, we should treat it like one. To be fair, many of these herbal drugs also have been used for centuries as foods, spices, or tonics, and are in general at least as safe as any of the well-known foods, food additives, and food ingredients in the American diet.
In contrast, there are also many herbs now sold as dietary supplements which have no prior history of having been used as foods or supplements to the human diet. They are, instead, strictly medicines that have been used to treat specific illnesses. The same holds true for pharmacologically active chemicals (drugs) recently discovered and isolated from herbs. Most consumers don’t know this. But when they realize that there are 2 types of herbal supplements - the true ones and the drugs - they can make informed decisions whether to assume the risk of taking the drugs, labeled as “dietary supplements,” on a regular and daily basis.
Why do we take so many drugs in the first place? And why are we Americans such an unhealthy bunch, despite our advances in medical, diagnostic, and pharmaceutical technologies? Or is our poor health because of them? Again, self-interest and greed play an important role in all this. I have already addressed our cancer problem in an earlier issue of this Newsletter (Issue 22, p. 2). The etiology, prevention, and treatment of other illnesses should not be too different than those of cancer, which could be sensibly dealt with to drastically reduce this number one scourge of our nation. But instead, we have been approaching these topics based primarily on self-interests. The most powerful and well-funded self-interests are the medical, pharmaceutical, and chemical lobbies, which have been responsible for shaping our drug-oriented culture. Now that most pharmaceutical giants have already entered the dietary supplements arena, they bring with them this same drug mentality and self-interests. Since there is no money in true prevention (which would make people healthier and thus reduce their need for drugs), prevention to these self-interests is to diagnose a disease early (often with the most expensive machinery), so that they can treat it with the newest and, of course, the most expensive, drugs. To them, it is a win-win setup, especially when they also profit mutually from one another’s endeavors.
Hence, to most consumers who have been thus primed, the easiest and most expedient approach to health is to use drugs (now “dietary supplements”) to take care of obvious symptoms. Changing of lifestyles or diet and taking true supplements to bring about good health and maintaining it is not in the cards, because it is less tangible and too slow to fit our national mentality of instant gratification. In addition, it is much more difficult to generate fast sales for the self-interests involved! Which is why we have natural medicines like ephedrine, synephrine, caffeine, St. John’s wort, huperzine A, kava kava, and melatonin generating brisk sales as dietary supplements. On the other hand, non-drug type of supplements such as flavonoids, lignans, polysaccharides, and certain terpenoids from foods and tonics which have no specific indications don’t sell well, at least to the general drug-oriented public. Typically, when a person is offered a “dietary supplement,” the first question he/she will ask is “What is it good for?” Yet this same person may take a one-a-day vitamin (a true supplement) without thinking twice what it will do for him/her. We are so obsessed with drugs and the glamour of biotechnology as well as the persistent but false promise of imminent cures that we have forgotten about the amazing things our body can do for itself and to give it a chance to work. Most of the time, our body does not need outside intervention, especially drugs. Yet we treat it as if it were an “idiot” without a “mind” of its own. If we continue to do that, it will lose its versatility and resilience; and it will succumb more easily to modern lifestyle diseases such as cancer and AIDS. Often, all our body needs is a good diet, some exercise, and the right nutrients. Some true dietary supplements will help. These are ones from herbs that have a long history of food use and are known to have been beneficial to generations past. They are not herbs that are actually drugs without having also been used safely in human history as foods, spices, condiments, or tonics.
(1) J.A. Astin, “Why Patients Use Alternative Medicine. Results of a National Study,” JAMA, 279(19): 1548-1553(1998); (2) D.M. Eisenberg et al., “Unconventional medicine in the United States: Prevalence, Costs, and Patterns of Use,” N. Engl. J. Med., 328: 246-252(1993).
RHODIOLA or HONG JING TIAN (Rhodiola spp.)
Some of you may have heard of “rhodiola” because over the past couple of years there has been quite a bit of hype about this herb. It is promoted as being better than ginseng in giving strength and stamina, increasing sexual vigor, and even antitumor, etc. If necessary, you can readily access the Western literature (especially European) to get information on the folk use, botany, chemistry and modern research findings on rhodiola. Here is information mostly from the Chinese literature sources which you may find useful.
Distribution. There are about 90 species of Rhodiola (family Crassulaceae) distributed worldwide, mostly in cold or elevated regions of the Northern Hemisphere. Among these, at least 73 grow in China, of which 55 on the Qinghai/Tibetan plateau. Rhodiola rosea L. [syn. Sedum rosea (L.) Scop.] is known in Chinese as hong jing tian, while all the other species bear names that are descriptive of their sources or plant characteristics. Thus, R. crenulata (HK. f. et Thoms.) H. Ohba is called da hua hong jing tian (da hua = large-flowered); R. tibetica (HK. f. et Thoms.) S.H. Fu is xizang hong jing tian (xizang = Tibetan); R. kirilowii (Regel.) Maxim. is xia ye hong jing tian (xia ye = narrow-leafed); and R. algida (Ledeb.) Fisch. et Mey. var. tangutica (Maxim) S.H. Fu is tang gu te hong jing tian; etc. However, the confusing thing is that “hong jing tian” is not used for Rhodiola rosea alone, but is also used as a drug name for other Rhodiola species.
Rhodiola rosea, the species that is purportedly used in American products, grows in northern and northwestern China (esp. Xinjiang, Shanxi, and Hebei) as well as in North America, from the Arctic region south along the coast to Maine and inland to Vermont, New York, Pennsylvania, and south to North Carolina.
Traditional/Modern Uses. Hong jing tian (Rhodiola spp.) has been used in Tibetan medicine for centuries primarily for nourishing the lung in treating lung diseases (e.g., pneumonia, cough, coughing blood), promoting blood circulation, as a febrifuge and detoxicant, and externally for burns and traumatic injuries; also considered to nourish and invigorate one’s primordial energy (zi bu yuan qi). Traditionally, the root and rhizome are used.
The use of rhodiola for its adaptogenic, tonic, anti-fatigue, central-stimulant, anti-toxic, anti-hypoxic, anti-aging, and/or memory-improving effects has been based on modern research findings, especially those by the Russians who have been using rhodiola in their products since the mid-1970’s. The Chinese started research on their own Rhodiola spp. (especially R. kirilowii) in 1987 and have since introduced numerous products based on rhodiola into the Chinese market.
Modern Chemical and Biological Findings. Various types of active compounds have been characterized from rhodiola or hong jing tian (root and rhizome). They include: p-tyrosol (b-p-hydroxyphenethyl alcohol) and its b-glucoside, salidroside; flavonoid glycosides (rhodionin, rhodiosin, rhodiolin, etc.); gallic acid, pyrogallol, ferulic acid, b-sitosterol, daucosterol, dihydrokaempferol, triterpenoids; rosavidine (reported unique to R. rosea); superoxide dismutase (SOD) isoenzymes, Cu-Zn-SOD and Mn-SOD (in R. sachalinensis A. Bor); volatile oil components; amino acids (up to 6.12% in R. sachalinensis); and others.
Chemicals found in aboveground parts of Rhodiola species include the flavonoid glycosides, rhodionidin, rhodiolgin, and rhodiolgidin. Other compounds also reported present in Rhodiola species (plant parts not specified) include: more flavonoids (gelidolin, rhodalide, rutin, litvinolin, etc.); coumarins (coumarin, umbelliferone, scopoletin, etc.); 6-diphenylmethyl pyridine (pyridrde); arbutin, skimmin, catechol, and others.
Most of the early pharmacological research was performed in Russia. Its pharmacologic effects have been shown to be very similar to those of eleuthero (Siberian ginseng). The active principles of rhodiola are generally considered to be salidroside, p-tyrosol, pyridrde, and rosavidine (in R. rosea). However, numerous other bioactive compounds, including ferulic acid, daucosterol, sitosterol, SOD isoenzymes, various flavonoid glycosides, and amino acids, should not be ruled out as active components of rhodiola.
Chinese Commercial Sources. Only a few species of Rhodiola are listed as the commercial source of rhodiola (hong jing tian) in China. They include: R. kirilowii; R. algida var. tangutica; R. fastigiata (HK. f. et Thoms.) S.H. Fu; R. quadrifida (Pall.) Fisch. et Mey.; R. sachalinensis; and R. crenulata. All, except R. sachalinensis (which grows in northeastern China, especially the provinces of Jilin and Heilongjiang), are distributed in western and southwestern China. Rhodiola rosea, purportedly used here in the U.S., is not listed as a commercial source in China or Tibet.
Due to the large number of species being used as source of rhodiola, it is extremely difficult to define the commercial material called “rhodiola” or hong jing tian. And unless the history of a particular rhodiola shipment can be traced back to the original plant, there is no guarantee that the material is genuine or from a particular species claimed as the source. Microscopic identification is also difficult, due to the lack of authenticated reference samples.
QA/QC Considerations. Based on its current (modern) usage, rhodiola is more a “Western” herb than a traditional Chinese or Tibetan herb. Before identification and quality control methods are well established, it is imperative that a botanical voucher specimen and authenticated samples of the root and rhizome from this specimen be obtained and used as reference standards for botanical, chemical and biological verification. Any extracts of “rhodiola” should have chromatographic patterns similar to that of the authenticated reference specimen, so as to prevent suppliers from spiking the extract with specific marker or active compounds that are made specially available to them. For example, p-tyrosol is widely present in fermentation products (wine, beer, vinegar, soy sauce, etc.) and can be selectively produced by fermentation.
Zhou, R.H., Ed. Zhong Yao Zi Yuan Xue (Chinese Herbal Drug Resources). Chinese Medical & Pharmaceutical Technology Publications, Beijing, 1993, pp. 278-286; Qinghai Provincial Institute of Drug Analyses & Qinghai Provincial Research Institute of Tibetan Medicine, Eds. Zhong Guo Zang Yao (Chinese Tibetan Medicines), Vol. 3. Shanghai Scientific & Technical Publications, Shanghai, 1996, pp. 372-374; Zheng, H.Z. et al., Eds. Zhongyao Xiandai Yanjiu Yu Yingyong (Modern Study of TCM), Vol. 6. Xue Yuan Press, Beijing, 1999, pp. 5658-5678.
Response to Readers
This Newsletter has been in print for close to 3 years now. It goes mainly to highly educated and technical readers, many of whom hold key positions in their organizations. Consequently, I can’t get away with any sloppy writing. And I sincerely appreciate that, because it keeps my brain young and alert.
Regarding the last issue (#25) of this Newsletter, a reader and colleague, Dr. Alvin Segelman, Vice President of Corporate Health Sciences of Nature’s Sunshine Products, Inc., wrote: “You state that the patients were given berberine tablets containing 1 gram each of berberine. Are you sure, Albert, that the tablets contain 1 gram of berberine?” Here is what I wrote in the last issue: “They were given berberine tablets 3 times daily (after meals), 1g each time.” The tablets were not 1 gram each, but 0.1 gram; and the patients had to take 10 tablets each time. I should have mentioned that to make it clearer. Thanks, Al, for pointing that out. Dr. Segelman also wrote: “I feel the same way about coffee as you do, and I have soporific effects of a cup of coffee before bedtime. Also, as of late I prepare coffee at home in the Turkish manner by adding 1 cup of boiling water to 1 tablespoonful of ground coffee bean, allowing the mixture to set for 3 minutes and then drinking the whole thing, grounds and all, hoping to increase my intake of chlorogenic acid, which is an excellent antioxidant and which people forget about.” By the way, I also happen to like Turkish coffee and Greek coffee, but I haven’t developed the taste for the grounds yet.
More on coffee (or is it caffeine?)
After my comments on coffee in the last issue of this Newsletter were published, coffee got a lot of press from a recently published study in JAMA (May 24/31). The study found that among 8,000 Japanese men living in Hawaii over a 30-plus-year period, those who drank coffee were less likely to develop Parkinson’s disease (PD) than those who drank none. Men who consumed 1 or 2 four-ounce cups of coffee daily had a risk of PD that was half that of non-coffee drinkers, while those who drank 7 cups or more daily were 5 times less likely to develop PD than the non-drinkers. I haven’t had a chance to read the original paper yet but I find the comments by the Editors of HealthNews (July 2000 issue), published by the Massachusetts Medical Society, most revealing. While on the one hand they admit the cause of PD is not understood, yet on the other hand they seem to be quite sure, as are the authors of the report, the 100-plus chemicals present in coffee have nothing to do with its PD-preventive activity. Citing the study authors, the editor(s) then go on to explain and postulate how caffeine, like cocaine and amphetamines (speed), act on the so-called dopaminergic system of the brain, and how caffeine “may indirectly enhance neurotransmission of dopamine, which could hide PD symptoms,” or “regular caffeine consumption over the years may preserve the neurons that transmit dopamine” etc. Throughout this article, as typical of scientists trained in non-natural product areas, they confuse caffeine with coffee, ignoring the many other pharmacologically active chemicals also present in coffee. After quoting all these studies and the evidence about the effects of caffeine which they illogically attribute to coffee (the bean), the editors’ recommendation is based simply on common sense: “Overall, moderate amounts of caffeine are deemed very safe. So go ahead and enjoy your morning brew, just don’t overdo it.” Indeed, common sense must always be part of science. As scientists, we need it to keep us in perspective. I wish the HealthNews editors would apply more common sense to their evaluation of research data as well. Instead of following only the chemical and pharmacological model of thinking, accepting caffeine as “the active” principle of coffee because it is a well-defined chemical and well studied, the editors should realize that coffee’s PD-preventive activity may lie in other chemicals present than caffeine. It is just common sense that caffeine may not be the only active compound in coffee which has this effect. There is nothing wrong in admitting that we don’t know something, rather than grabbing onto a thread of thin evidence and try to fit what we don’t know into an existing, comfortable but deficient model. After all, hypothesis is a hypothesis until proven otherwise, and there are already too many of these in the natural product field! Do we need another one?