Bakrim, A., A. Maria, et al. (2008). “Ecdysteroids in spinach (Spinacia oleracea L.): Biosynthesis, transport and regulation of levels.” Plant Physiology and Biochemistry 46(10): 844-854.

Many plant species produce phytoecdysteroids (PEs: i.e. analogues of insect steroid hormones). There is increasing evidence that PEs are used as a chemical defence by plants against non-adapted insects and nematodes. PEs are good candidates for the development of an environmentally safe approach to crop protection. Most crop species do not accumulate PEs. However, many arguments support the idea that most, if not all, plant species have the genetic ability to produce PEs, but the biosynthetic pathway is not active. A better understanding of the PE biosynthetic pathway and its regulation is consequently necessary. Spinach is one of the very few crop plants which produce large amounts of PEs, of which 20-hydroxyecdysone is the major component. Labeling experiments with radiolabeled precursor (mevalonic acid), putative ecdysteroid intermediates and 20-hydroxyecdysone itself have allowed investigation of PE biosynthesis and transport during spinach development. Biosynthesis takes place in older leaf sets (”sources”), but not in the young developing ones, which in contrast accumulate (acting as “sinks”) the PEs produced by the older leaves. PEs are thus continuously redistributed within the developing plant, as its leaf set number increases. The biosynthetic pathway has been analyzed using excised leaves and various labeled precursors, and a preferential sequence of the last steps has been established. Although they do not produce PEs, apical leaf sets are nevertheless able to perform several putative terminal steps of PE biosynthesis. The regulatory mechanisms of PE synthesis appear to involve a direct negative feedback of 20-hydroxyecdysone (the major PE in spinach) on its own synthesis; thus, a sustained synthesis in older leaves requires that they can export the PE they produce.

Biederman’s career highlights include a series of clinical trials to “prove” the efficacy of the ADHD drug atomoxetine (Strattera). Unlike Ritalin, this is not a direct stimulant, but appears to function as a norepinephrine reuptake inhibitor. (indirect stimulant for FWIW) The drug is made by Ely Lilly, one of Biederman’s major undisclosed sponsors (see earlier HERBLOG post about his failure to truthfully disclose conflict of interest payments.)

As discussed in the last HERBLOG post, the author’s justification for this clinical trial included the absurd claim that because 5 kids in Texas might have taken SJW for ADHD or depression, that Hypericum is the most prescribed herb for this “condition” of ADHD in the whole of the USA. On the same topic - ( ie Why the F***? ) there is yet another preposterous claim in the paper. In the introduction to the study, the authors state that …“since the NE uptake inhibitor atomoxetine has been approved by the FDA for ADHD and because Hypericum is believed to act as a norepinephrine reuptake inhibitor, we hypothesized that it may be beneficial in the treatment of ADHD….”

This so-called hypothesis is unmitigated nonsense.

Hypericum is NOT a NE reuptake inhibitor. That term refers to the pharmacological action of a drug (such as atomoxetine). Hypericum is a mild herb. Mild herbs are not drugs. They do not display drug type magic bullet actions. Hallo - Bastyr…come in please…where are you???? Do we really have to go through the fact that SJW is not a NERI, not an MAOI, not an SSRI, not even all of the above….

But for Biederman and Ely Lilly to be able to say that the Hypericum or any herb for that matter, does not work for ADHD…is to say the least convenient, if somewhat marginal. Sounds like a bit of a set up? Sounds like Bastyr folk walked right into it too. Nothing like an Institution that teaches botanical medicine saying that a her b does not work..it really must mean it does not work. Maybe they did not see the headlines coming….what headlines?

What headlines?….See next post.

According to the full text The Bastyr Hypericum/ADHD trial used a SJW product supplied by Vital Nutrients Inc that is “marketed as standardized to 0.3% hypericin”. The text further relates this material was “independently” verified prior to the trial, and also suggests that the extract was not a high hyperforin ( 3-5%) type of product. This is part of the end discussion in the paper that suggested the effects being tested were a result of hypericin not hyperforin.

An interesting point emerges here: Vital Nutrients Inc is a reputable company run by Bastyr alum Dr Rik Liva. Liva has established a solid reputation in the natural products industry as a vigorous proponent of GMPs, quality assurance and the need for testing to ensure quality in dietary supplements. He has often gone on public record as saying that adherence to QA/GMPs is absolutely necessary to prevent the public from being duped. But when his owncompany’s extract was tested it was found to be 0.13% hypericin not 0.3% as labelled. This is a huge discrepancy. Perhaps the “independent” testing of the initial material was simply a wholesale suppliers “C of A (Certificate of Assurance) about the quality? A further puzzle is that Vital Nutrients do not actually market a “low hyperforin” SJW product. Their web site lists only a 3-5% hyperforin SJW item

SO it could be said that Liva’s Vital Inc producthad the potential for duping the consumer, it duped the triallists at any rate. The abstract could easily have read something like “egg on face as clinical trial fails to measure anything due to clusterfuck confusion over product administered to verum group” but then that would not have made the study authors or their Bastyr alum’s company look too clever.

Since Liva is pretty adept at publicity, perhaps we will be hearing from him about the apparent problems with the product used in the trial. Perhaps the “independent verification” of the supplied material could be revealed? The Bastyr paper itself suggests that the product probably became oxidized during the 8 week trial due to its being dispensed in 2- part capsules. One would hope for a longer than 8 week shelf life for most products….Perhaps Liva will shortly be reoutfitting the Vital Nutrients SJW in a “onezie” suit.

To be continued..

As Dr Yarnell rightly points out - one really cannot criticize a study without reading the full text. So now we have the study, and the story continues to unravel. Here is one little issue…..

The material used in the study contained, when tested at the end of the 8 week trial period, 0.13% hypericin. The abstract states that the material was 0.3% standardized. So the material was less than half the strength stated in the abstract. An explanation was given that hyperforin is unstable and may have oxidised. However, the hypericin was the critical ingredient here, not hyperforin. In fact the Vital Nutrients Inc material was not a high hyperforin extract in the first place. The plot thickens.

So the question is why does the abstract say one thing and the full text another? BS science as usual… Dr Yarnell is indeed correct.

Hypericum perforatum (St John’s Wort) for Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Randomized Controlled Trial.

Dr Joseph Biederman is a nasty piece of work. He is a pediatric psychiatrist and a major advocate of medicating young children with psychiatric medications for DSM conditions such as ADHD and pediatric bipolar disorder. The diagnosis of peeds bipolar cases rose 4000% in the decade from 1994-2003, and sales of pharma drugs to “treat” or chemically control the so-called condition doubled from 2003 to 2006 according to Natural News Reporter Mike Adams who recently covered Senator Charles Grassey’s expose of Biederman’s funding lies following the revelations made by NYT reporters Harris and Carey last month.

As the NYT reported, Biederman failed to disclose at least $1.6 million consultancy fees from Big Pharma until investigated by Senator Grassley. Biederman and his colleagues Wilens and Spencer, all notorious advocates of child drugging, have “uprated” their conflict of interest estimated income following enquiries by Grassley. To protect research integrity, the NIH who funded Mass General Hospital to the tune of $287 million in 2005 for research requires researchers to report consultancy fees, and at that time HArvard forbade researchers from conducting clinical trials if they received more than $10,000 pa in such fees. The NYT gives a typical example - Biederman suggested that Johnson and Johnson paid him $3,500 in 2001, ie less than $10,000, but the company admitted the figure was in fact$58,000.

Failing to report income by researcher is a possible violation of Federal and University rules. Mass General theoretically could lose NIH funding as a result of this scandal, but it seems pretty unlikely - at this time, Biederman’s case has been referred to a Harvard “University Committee” for review.

Ironically, another well known right wing psychiatrist, Fuller Torrey of the Stanley Research Institute, rounded on the Biederman fiasco in public saying “In the area of child psychiatry in particular..we desperately need research that is not influenced by industry money. The price we pay for these kind of revelations is credibility, and we just can’t afford to lose anymore in this field” reports the NYT.

So what’s new about such sordid conflict of interest revelations? Just that the same Dr Joseph Biederman is an author of the Bastyr study on ADHD and Hypericum that found the herb did not work. Better just take the drugs heh?

Bastyr’s defenders would probably say something like well we needed an acknowledged “expert” in the field in which we were going to run a trial…we would say, you can tell a lot about someone by the company they keep.

Here we go. Edzard is at it again. What a complete and utter craphead this guy is. If you read the fine print (= full text) of this profound exercise in masturbatory metastudy fantasia you will find that this study’s male authors decided (in their infinite [lack of] wisdom, and very finite lack of practical clinical experience as well as complete and utter incomprehension of the real world outside of their warped academic wankdom) to exclude studies that related to menopause induced by chemotherapy or surgery. So, as anyone with half an ounce of clinical experience knows, menopause induced by sudden surgical or cytotoxic chemotherapeutic trauma precipitates the most extreme symptoms that are profoundly distressing for those experiencing them. Black cohosh works for these folk. It works every time. All the time. It works so well that I have had patients kicking down the door to replenish their supplies of BC tincture when they even suspect they might have run out over the weekend. So you have to take enough. If you take enough…it works. The typical trial doses are less than 100 mg qd. How did they figure that out? Try an order of magnitude more. Its a herb. It won’t kill you. And it works. The contrast between the simple beauty and elegance of the real world effectiveness of this herb for menopausal symptoms and the pronouncements of the self-appointed high priests of evidence based medicine about the same herb is, I suppose, in the end, an expression of how profoundly screwed things really are today. Further rigorous trials are indeed warranted. Preferably the accused will be Ernst and his ilk.

Black cohosh (Cimicifuga racemosa) for menopausal symptoms: A systematic review of its efficacy.

Pharmacol Res. 2008 Jun 8;

Authors: Borrelli F, Ernst E

Since conventional hormone replacement therapy has fallen out of favour, alternatives are being sought by many women. These therapies include herbal preparations such as black cohosh (Cimicifuga racemosa). The purpose of this update of a previous systematic review is to evaluate the clinical evidence for or against the efficacy of black cohosh in alleviating menopausal symptoms. Five computerized databases (Medline, Embase, Amed, Phytobase and Cochrane Library) were searched to identify all clinical data that provided evidence on the efficacy of C. racemosa. Bibliographies of the articles thus located were scanned for further relevant publications. Only double blind, randomized, clinical trials (RCTs) were included in the evaluation of efficacy. No language restrictions were imposed. Trials were excluded if they did not focus on menopausal problems, they included women suffering medically induced menopause, they did not use black cohosh monopreparations, or they did not use placebo or a standard drug treatment for the control group. Six studies with a total of 1112 peri- and post-menopausal women met our inclusion criteria. The evidence from these RCTs does not consistently demonstrate an effect of black cohosh on menopausal symptoms; a beneficial effect of black cohosh on peri-menopausal women cannot be excluded. The efficacy of black cohosh as a treatment for menopausal symptoms is uncertain and further rigorous trials seem warranted.

PMID: 18585461 [PubMed - as supplied by publisher]

(Via Herbal Science Research aggregator.)

Our last HERBLOG post regarding the Bastyr ADHD study attracted email comment, controversy and criticism. All of which is good. With Word Press comments disabled you never know if anyone is bothering to read a blog.

Thanks to Paul Bergner of the North American Institute of Medical Herbalism and Editor of the journal Medical Herbalism pointed out that Dr John Bastyr was not a founder of Bastyr University. The four founders of Bastyr were Bill Mitchell, Joe Pizzorno, Les Griffith and Sheila Quinn. As Bill Mitchell wrote in his book Plant Medicine in Practice, Bastyr was a towering figure of American botanical medicine, the “best of the best”. Bergner reports that being in the presence of this master clinician was amazing, and Bill Mitchell’s book gives a flavor of the man to those of us who were not fortunate enough able to meet him or hear him teach.

Bastyr University teaches Botanical Medicine as part of its core curriculum for Naturopathic Physicians, and arguably has one of the best botanical departments in North America at this time, which also offers a Herbal Sciences undergraduate degree, oriented more towards those considering non-clinical careers in the herb industry.

Dr Eric Yarnell, a current core faculty member at Bastyr’s Botanical Medicine department, defends the ADHD study and criticizes my post statement that Bastyr is joining the chorus that Hypericum does not work as a wild exaggeration. Eric suggests that since HYpericum is in fact a popular remedy with self medicating public for ADHD, it is reasonable to see if it works or not. He also suggests I read the whole paper, which I did not. Fair comment. His points are worth looking at in detail, which we will do in the next post.

So JAMA publishes a trial run out of Bastyr University, the renowned Naturopathic college in Seattle, which resoundingly informs us that SJW does not work for ADHD? What a total waste of time and money. What herb have they been smoking up there in Seattle? Is there a herbally literate practitioner anywhere who would recommend SJW as a single agent for a behavioral pattern such as “ADHD”. The centres of excellence so called in natural medicine would be better occupied in dismantling the ADHD “label” - instead of regarding it as disease that might be cured by a single herb given as a druand en route adding to the “SJW does not work” chorus.One wonders what the founders of Bastyr - Dr John Bastyr and Dr Biill Mitchell would think of such an unsavoury scenario.

Hypericum perforatum (St John’s Wort) for Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Randomized Controlled Trial.

JAMA. 2008 Jun 11;299(22):2633-41 Weber W, Vander Stoep A, McCarty RL, Weiss NS, Biederman J, McClellan J  

CONTEXT: Stimulant medication can effectively treat 60% to 70% of youth with attention-deficit/hyperactivity disorder (ADHD). Yet many parents seek alternative therapies, and Hypericum perforatum (St Johns wort) is 1 of the top 3 botanicals used. OBJECTIVE: To determine the efficacy and safety of H perforatum for the treatment of ADHD in children. DESIGN, SETTING, AND PARTICIPANTS: Randomized, double-blind, placebo-controlled trial conducted between March 2005 and August 2006 at Bastyr University, Kenmore, Washington, among a volunteer sample of 54 children aged 6 to 17 years who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for ADHD by structured interview. INTERVENTION: After a placebo run-in phase of 1 week, participants were randomly assigned to receive 300 mg of H perforatum standardized to 0.3% hypericin (n = 27) or a matched placebo (n = 27) 3 times daily for 8 weeks. Other medications for ADHD were not allowed during the trial. MAIN OUTCOME MEASURES: Performance on the ADHD Rating Scale-IV (range, 0-54) and Clinical Global Impression Improvement Scale (range, 0-7), and adverse events. RESULTS: One patient in the placebo group withdrew because of an adverse event. No significant difference was found in the change in ADHD Rating Scale-IV scores from baseline to week 8 between the treatment and placebo groups: inattentiveness improved 2.6 points (95% confidence interval [CI], -4.6 to -0.6 points) with H perforatum vs 3.2 points (95% CI, -5.7 to -0.8 points) with placebo (P = .68) and hyperactivity improved 1.8 points (95% CI, -3.7 to 0.1 points) with H perforatum vs 2.0 points (95% CI, -4.1 to 0.1 points) with placebo (P = .89). There was also no significant difference between the 2 groups in the percentage of participants who met criteria for improvement (score </=2) on the Clinical Global Impression Improvement Scale (H perforatum, 44.4%; 95% CI, 25.5%-64.7% vs placebo, 51.9%; 95% CI, 31.9%-71.3%; P = .59). No difference between groups was found in the number of participants who experienced adverse effects during the study period (H perforatum, 40.7%; 95% CI, 22.4%-61.2% vs placebo, 44.4%; 95% CI, 25.5%-64.7%; P = .78). CONCLUSION: In this study, use of H perforatum for treatment of ADHD over the course of 8 weeks did not improve symptoms.

Trial Registration clinicaltrials.gov Identifier: NCT00100295.PMID: 18544723 [PubMed - in process]

(Via Herbal Science Research aggregator.)

This evening a friend of mine sent me an email allegedly from John (sic) Hopkins, making a series of radical claims in numbered paragraphs about the nature of cancer and alternatives to conventional tmedicine for its prevention and treatment. My friend had been sent the email by her father, an elderly prostate cancer survivor, who thought the article was genuine and very important.Now, whether you are into CAM/non conventional medicine or not, you have to agree that Johns Hopkins is a seriously heavyweight institution with some outstanding physicians involved in cutting edge research , especially in fields like cancer and HIV/AIDS. At any rate, they would be likely to be able to spell the name of their organization correctly. (Danger sign 1). IN fact, for anyone reasonably literate in cancer research or clinical oncology, every single paragraph in the scammy text of the email that purported to be from Hopkins read as though it were written by someone semi-literate not only in the basics of cancer  but also in english grammar… for example

2. Cancer cells occur between 6 to more than 10 times in a person’s lifetime.   

Hmmm - pretty fishy? Oh yes. A quick google search reveals tens of dozens of sites reproducing the so called email letter … but none of them link to any reputable source, including Johns Hopkins. But stroll over to Hopkins’ web site and lo and behold….the following denial is posted…Email Hoax Regarding CancerFrom receipt of email to establishment of its hoax provenance took me less than 5 minutes. The fascinating thing is how mindlessly different people propagate and circulate these kind of myths - to the point where copies are posted and reposted all over cyberspace until they take on a life of their own - and it happens so FAST! Food for thought huh.The (bodged) text of the original email that is still circulating is reproduced here: you can google the title anywhere…

AFTER YEARS OF TELLING PEOPLE CHEMOTHERAPY IS THE ONLY WAY TO TRY AND ELIMINATE CANCER, JOHN HOPKINS IS FINALLY STARTING TO TELL YOU THERE IS AN ALTERNATIVE WAY . 1. Every person has cancer cells in the body. These cancer cells do not show up in the standard tests until they have multiplied to a f ew billion. When doctors tell cancer patients that there are no more cancer cells in their bodies after treatment, it just means the tests are unable to dete ct the cancer cells because they have not reached the detectable size.2. Cancer cells occur between 6 to more than 10 times in a person’s lifetime.3. When the person’s immune system is strong the cancer cells will be destroyed and prevented from multiplying and forming tumors.4. When a person has cancer it indicates the person has multiple nutritional deficiencies. These could be due to genetic, environmental, food and lifestyle factors.5 To overcome the multiple nutritional deficiencies, changing diet and including supplements will strengthen the immune system.6. Chemotherapy involves poisoning the rapidly-growing cancer cells and also destroys rapidly-growing healthy cells in the bone marrow, gastrointestinal tract etc, and can cause organ damage, like liver, kidneys, heart, lungs etc.7. Radiation while destroying cancer cells also burns, scars and damages healthy cells, tissues and organs.8. Initial treatment with ch emotherapy and radiation will often reduce tumor size . However prolonged use of chemotherapy and radiation do not result in more tumor destruction.9. When the body has too much toxic burden from chemotherapy and radiation the immune system is either compromised or destroyed, hence the person can succumb to various kinds of infections and complications.10. Chemotherapy and radiation can cause cancer cells to mutate and become resistant and difficult to destroy. Surgery can also cause cancer cells to spread to other sites.11. An effective way to battle cancer is to starve the cancer cells by not feeding it with the foods it needs to multiply. CANCER CELLS FEED ON:a Sugar is a cancer-feeder. By cutting off sugar it cuts off one important foo d supply to the cancer cells. Sugar substitutes like NutraSweet, Equal,Spoonful, etc are made with Aspartame and it is harmful. A better natural substitute would be Manuka honey or molasses but o nly in very small amounts. Table salt has a chemical added to make it white in color. Better alternative is Bragg’s aminos or sea salt.b. Milk causes the body to produce mucus, especially in the gastrointestinal tract. Cancer feeds on mucus. By cutting off milk and substituting with unsweetened soy milk cancer cells are being starved.c. Cancer cells thrive in an acid environment. A meat-based diet is acidic and it is best to eat fish, and a little chicken rather than beef or pork. Meat also contains livestock antibiotics, growth hormones and parasites, which are all harmful, especially to people with cancer.d. A diet made of 80% fresh vegetables and juice, whole grains, seeds, nuts and a little fruit help put the body into an alkaline environment. About 20% can be from cooked food including beans. Fresh vegetable juices provide live enzymes that are easily absorbed and reach down to cellular levels within 15 minutes to nourish and enhance growth of health y cells. To obtain live enzymes for building healthy cells try and drink fresh vegetable juice (most vegetables including bean sprouts) and eat some raw vegetable s 2 or 3 times a day. Enzymes are destroyed at temperatures of 104 degrees F (40 degrees C).e. Avoid coffee, tea, a and chocolate, which have high caffeine. Green tea is a better alternative and has cancer-fighting properties. Water-best to drink purified water, or filtered, to avoid known toxins and heavy metals in tap water. Distilled water is acidic, avoid it.12. Meat protein is difficult to digest and requires a lot of digestive enzymes. Undigested meat remaining in the intestines become putrefied and leads to more toxic build-up.13. Cancer cell walls have a tough protein covering. By refraining from or eating less meat it frees more enzymes to attack the protein walls of cancer cells and allows the body’s killer cells to destroy the cancer cells.14. Some supplements build up the im mune system (IP6, Flor-ssence, Essiac, anti-oxidants, vitamins, minerals, EFAs etc.) to enable the body’s own killer cells to destroy cancer cells. Other supplements like vitamin E are known to cause apoptosis, or programmed cell death, the body’s normal method of disposing of damaged, unwanted anted, or unneeded cells.15. Cancer is a disease of the mind, body, and spirit. A proactive and positive spirit will help the cancer warrior be a survivor. Anger, resentment, and bitterness put the body into a stressful and acidic environment. Learn to have a loving and forgiving spirit. Learn to relax and enjoy life.16. Cancer cells cannot thrive in an oxygenated environment. Exercising daily, and deep breathing help to get more oxygen down to the cellular level. Oxygen therapy is another means employed to destroy cancer cells. CANCER UPDATE FROM JOHN HOPKINS HOSPITAL , U S A < /SPAN>1. No plastic containers in micro.2. No water bottles in freezer.3. No plastic wrap in microwave.Johns Hopkins has recently sent this out in its newsletters. This information is being circulated at Walter Reed Army < /FONT>Medical Center as well. Dioxin chemicals cause cancer, especially breast cancer.Dioxins are highly poisonous to the cells of our bodies.Don’t freeze your plastic bottles with water in them as this releases dioxins from the plast ic.Recently, Dr. Edward Fujimoto, Wellness Program Manager at Castle Hospital , was on a TV program to explain this health hazard. He talked about dioxins and how bad they are for us.. He said that we should not be heating our food in the microwave using plastic containers.This especially applies to foods that contain fat. He said that the combination of fat, high heat, and plastics releases dioxin into the food and ultimately into the cells of the body. Instead, he recommends using glass, such as Corning Ware, Pyrex or ceramic containers for heating food. You get the same results, only without the dioxin. So such things as TV dinners, instant ramen and soups, etc., should be removed from the container and heated in something else.Paper isn’t bad but you don’t know what is in t he paper. It’s just safer to use tempered glass, Corning Ware, etc. He reminded us that a while ago some of the fast food restaurants moved away from the foam containers to paper. The dioxin problem is one of the reasons.Also, he pointed out that plastic wrap, such as Saran, is just as dangerous when placed over foods to be cooked in the microwave. As the food is nu ked, the high heat causes poisonous toxins to actually melt out of the plastic wrap and drip into the food. Cover food with a paper towel instead. This is an article that should be sent to anyone important in your life.   

Rwandan female genital modification: Elongation of the Labia minora and the use of local botanical species
Koster M, Price LL, Cult Health Sex. 2008 Mar-Apr;10(2):191-204

The elongation of the labia minora is classified as a Type IV female genital mutilation by the World Health Organization. However, the term mutilation carries with it powerful negative connotations. In Rwanda, the elongation of the labia minora and the use of botanicals to do so is meant to increase male and female pleasure. Women regard these practices as a positive force in their lives. This paper aims to assess whether Rwandan vaginal practices should indeed be considered a form of female genital mutilation and whether the botanicals used by women are detrimental to their health. Research was carried out in the northeast of Rwanda over the course of 13 months. Semi-structured interviews were conducted with thirteen informants. Two botanicals applied during stretching sessions were identified as Solanum aculeastrum Dunal and Bidens pilosa L. Both have wide medicinal use and contain demonstrated beneficial bioactive compounds. We suggest that it is therefore more appropriate to describe Rwandan vaginal practices as female genital modification rather than mutilation.

PMID: 18247211 [PubMed - in process]