Melatonin has recently been shown to reverse the protein complex that is the hallmark of Alzheimer's disease, according to a study published in the December 11, 2001 issue of Biochemistry, published by the American Chemical Society.
Besides acting as a neurotransmitter, melatonin is a powerful brain antioxidant, which easily crosses the blood-brain barrier when taken as a supplement. A large intervention study ("Alzheimer's Disease Cooperative Study") demonstrated that high doses of vitamin E (2,000 IU per day) could slow the progression of moderately advanced AD in human subjects. This effect was thought to be mediated through the antioxidant function of vitamin E. Vitamin E does not easily cross the blood-brain barrier, whereas melatonin very easily enters the brain from the general circulation. In the current study, only melatonin protected brain cells from amyloid beta protein build up and toxicity. Trials with vitamin C, vitamin E and a synthetic antioxidant were not protective in this study.
More research is required before any definitive statements can be made regarding the use of melatonin and the prevention of AD; however, interested practitioners should go to http://www.chiroweb.com/audio/meschino and listen to my internet radio interview with Dr. Russell Reiter (University of Texas, San Antonio) on the program "Interviews With Health Experts." Dr. Reiter is a professor of neuroendocrinology, and is considered by many to be the world's leading authority on melatonin research. During the interview, he discusses the use of melatonin as a prophylactic agent in the prevention of AD and how he personally uses this naturally occurring substance in his own life.
It should be recognized that melatonin levels decline with age, and this may in part account for the brain's increased susceptibility to dementia and AD that accompany aging. Antioxidants, including melatonin, and B vitamins are emerging as important natural agents that demonstrate an ability to inhibit many of the pathological changes to brain cells that occur in AD and other forms of cognitive impairment. (See related articles at http://www.renaisante.com for more details and references on this subject.) As such, AD may be more preventable than previously recognized, through the use of a prudent strategy, involving diet and the appropriate introduction of certain supplements at critical points within the lifecycle. The recent study by Pappolla, et al., serves to strengthen this argument.
Reference
Pappola M, et al. Biochemistry, 2001.
Kava May Increase Risk of Liver Disease
Kava and its active ingredients, kavalactones, are well recognized in the world of herbal medicine for their calming and anti-anxiolytic properties. From a pharmacologic standpoint, kava's active ingredients produce similar EEG changes to the drug diazepam, producing tranquilizing and other effects closely related to drugs that bind to benzodiazepine receptors in the brain. It has previously been reported that, among other potential side effects, the long-term use of kava may cause yellowing of the skin, which may reflect undesirable changes in the liver.1
At the end of 2001, reports surfaced in the European and the U.S. consumer press linking the consumption of kava to liver disease. Concerns about kava stem from case reports from Germany and Switzerland that identify the herb as a possible causative agent in liver toxicity and liver failure. Based on these reports, the UK has banned sales of kava products pending investigation, and German authorities have notified manufacturers of kava products that their licenses to market the herb could be withdrawn.
Prior to these reports, kava's safety record in the U.S. was relatively unchallenged. While the Food and Drug Administration (FDA) has not communicated directly with the public about any potential dangers associated with kava, a letter to health care practitioners issued December 18, 2001 states that it is investigating whether kava products marketed in the U.S. pose a public health concern. The agency noted that approximately 25 cases of sometimes-serious liver toxicity have reportedly been associated with kava consumption by German and Swiss health authorities.
In a conference call with trade representatives on December 18, the FDA informed associates that its letter to health care practitioners was meant to serve as a data-gathering tool and is not issued as a warning or alert. In the U.S., some kava-related liver damage has been reported through the MedWatch reporting system of adverse events, and these cases are now being followed-up as part of the investigative process.2
References
- Boon H, Smith M. The Botanical Pharmacy, Quarry Health Books, 1999: 215-219.
- Kava safety concerns raised. National Nutritional Foods Association Update, December 21, 2001.
Vitamin B Supplementation of Value in Postangioplasty Patients
According to a report in the November 29, 2001 issue of the New England Journal of Medicine, patients who underwent angioplasty - a balloon-tipped catheter, which pushes aside fatty deposits in coronary arteries to improve blood flow - were less likely to see their arteries narrow within six months if they took a combination of folic acid and vitamins B12 and B6 (pyridoxamine). This study included 205 postangioplasty patients who received either a combination of one mg (1,000 mcg) of folic acid, 400 mcg of Vitamin B12 and 10 mg of Vitamin B6 or a placebo for six months.
The results showed that restenosis occurred in less than 20 percent of the vitamin therapy patients compared with nearly 38 percent of patients who took the placebo. Patients who followed the vitamin regimen also had fewer cardiac events, including heart attacks, in the months following the angioplasty procedure. Folic acid and vitamins B6 and B12 work synergistically to prevent the excess build-up of homocysteine from occurring. These B-vitamins act as cofactors in important enzyme reactions that convert homocysteine into methionine or into cystathionine. In a state of suboptimal nutritional status of any of these B-vitamins, homocysteine can more readily accumulate within body cells. Once reaching a critical threshold level, homocysteine diffuses out of cells to enter the bloodstream. In the bloodstream, homocysteine has been shown to oxidize LDL-cholesterol, promote vasoconstriction of arteries, and increase platelet aggregation, all of which increase the risk of heart disease and ischemic stroke. Many studies indicate that high blood levels of homocysteine increase the risk of heart disease and stroke, and that as much as 10 percent of the risk of heart disease is attributable to blood homocysteine levels. (For more details and references on this subject, visit www.renaisante.com.) As such, folic acid and vitamins B6 and B12 are emerging as important anti-heart disease nutrients in the fight against America's number-one killer.
Reference
Schnyder G, et al. N Engl J Med. Nov. 2001.
White Willow Bark Extract Reduces Low Back Pain
White willow bark extract has been shown to produce analgesic and anti-inflammatory effects, primarily due to the presence of its phenolic glycoside content. One of these phenolic glycosides includes salicylic acid, which differs from acetyl salicylic acid (ASA) in that ASA is synthetically produced and inhibits platelet function, whereas salicylic acid is naturally-occurring, more slow-acting and does not impair platelet function.1
Reporting in the American Journal of Medicine in 2000, Chrubasik, et al., published findings to show that patients who took a standardized grade of white willow bark had significant recovery from chronic low back pain compared with patients given the placebo. Thirty-nine percent of patients given the white willow bark extract realized a significant degree of pain reduction (usually within the first week), compared to only six percent of patients in the placebo group. Only one patient reported any adverse side effects to the treatment with white willow bark, which involved swollen eyes and itching, consistent with an allergic reaction.2 These findings support the work of other investigators who have published reports, indicating that white willow bark extract is effective in the treatment of low back pain and other inflammatory musculoskeletal conditions of mechanical origin (i.e., Shmid B, Fact 1998, 3:186). As such, holistic health care practitioners involved in the treatment of low back pain may consider the inclusion of a supplement containing white willow bark extract as a part of the complementary treatment in the management of chronic and acute mechanical low back pain. White willow bark should be standardized to 15-percent salicin content, and a daily dose of 100-240 mg is typically recommended. If it is taken in conjunction with other natural anti-inflammatory agents (i.e., curcumin, boswellia, etc.), a daily dose as low as 100 mg is usually sufficient.
References
- Mills S, Bone K. Principles and Practice of Phytotherapy, Churchill Livingstone 2000: 22-25.
- Chrubasik S, et al. Treatment of low back pain exacerbations with white willow bark extract: A randomized double-blind study. Am J Med 2000;109:9-14.
Please take time to listen to Dr. Meschino's interviews on ChiroWeb.com. The subjects of the first three are: Combining Traditional, Complementary and Natural Interventions, The Benefits of Melatonin, and Using Natural Remedies to Manage Women's Health Issues. Each interview is packed with important information available to you and your patients. You can listen to the interviews at http://www.chiroweb.com/audio/meschino. There is a link on the directory page for your feedback.
James Meschino,DC,MS
Toronto, Ontario
Canada
www.renaisante.com
Click here for more information about James P. Meschino, DC, MS.