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Basics of Botanical Research

The research process is beautiful. And fun! You get to navigate and interact with the landscape of information about a subject, and figure out where the strengths, weaknesses, and opportunities exist in our knowledge base. In the process of digging into research, you can see the origins of the rumors spread about herbs, gain some clarity about it and weed through misinformation. Certainly, botanical preclinical and clinic research is an incremental way of building undertanding, much like an ant procuring crumbs of food to bring back to the colony. And it doesn’t tell us everything: there are many rich sources of information to draw from in botanical medicine, with traditional use chief among them. The skilled herbalist exercises good judgment and critical thinking by achieving fluency in these different areas, and knows how to apply them to help people.

I’ve been in the research field for 6 years–first in anthropological research at the Center for World Indigenous Studies, then as a botanical research assistant and writer for several clinicians, and now in R&D for a medicinal mushroom company. And I’m passionate about supporting herbalists in navigating the scientific research about botanicals and supplements to improve decision-making.

Let’s use an example. Say you’ve been heard about Thyme Oil as a Powerful Natural Antibiotic on social media sites and want to dig further into it. When we’re looking for at the evidence base of a claim, we want to go to the primary research and see the studies that have actually been done. Not reviews, not news articles, but real studies.

Frame the question to structure the inquiry.

I usually make 2 columns: the first lists the substance I’m searching for. This can be a specific plant, phytochemical, or just plants in general. Use the latin name for plants (in this case Thymus vulgaris), and include potential misspellings. Then in the second column is the subject: the name of a condition, keyword, or associated biomarker (you can use the term antibiotic or antibacterial). In this case, there’s a MeSH term for anti infective agents, which would cover the territory nicely.

Get better at searching.

You can then use this basic format to search the databases. Searching MEDLINE via PubMed will be more helpful with complex searches, as you can specify which fields you’d like to search. I also like to search Google Scholar. It indexes MEDLINE as well as other databases. The search is wider and you get more results, but you can’t customize it as well as you can with PubMed. Below is the search builder on PubMed. As you can see, you can add lots of different criteria for more wheat and less chaff.

Screen Shot 2014-12-13 at 10.14.37 AMAnd get to know your journals–PLOS, PubMed Central, BioMed Central, and anything from the Hindawi Publishing Group is free full text. My favorite botanical/phytotherapy journals are Fitoterapia, Phytotherapy, Phytotherapy Research, and Planta Medica. The Journal of Ethnopharmacology is also a great one, but I get the feeling that it’s a bioprospecting publication.

Use reference management programs to store and organize citations.

Once you start generating citations, programs like EndNote, Papers, Mendeley (free), Zotero (free), and Sente (pictured below, my personal favorite) can store, track and organize your citations. With any software, each have their different strengths and weaknesses. For example, EndNote is great for formatting citations in a final publication, but not the best at organizing into folders, tagging, storing PDFs. Sente is my personal favorite because I can sync these libraries with research colleagues, store and annotate PDFs, and having standing searches to keep up on new search results as they come in. Mendeley is a nice free/open source program, and is a good place to start.

Sente screenshotI have several of these programs installed. I can import and export citations as needed, depending on the project.

Going from A to B: know how to extrapolate and interpret data relevant to your inquiry.

This is where the true skill lies in research. Investigators set up replicas of reality in their labs. I can’t stress enough that research findings are specific to that setting, model, and process. Assessing the relevance of a finding is crucial. How do we translate study A to real world situation B? This takes some understanding of human biology, test methods, and the strength of different types of research methodologies and evidence (which I’ll address in future posts).

Back to thyme oil: once you complete your search, you’ll see that there is some data on antibacterial effects. Great! You have something to work with. Then the researcher should consider:

  • Were these done in test tubes (in vitro), animals, or humans?

In vitro studies are done in test tubes, often by culturing cells with botanical extracts, concentrates or isolates. They’re done to investigate the mechanism by which something works, and/or to see if there’s enough of an effect for research efforts to progress to animal studies. As the body would metabolize these compounds differently than what’s done in petris, findings should be taken with a grain of salt as they’re difficult to extrapolate to real world situations.

  • What kind of bacteria? What exactly were the effects?

This is very important! Just because a substance has an effect on a particular genus, species, or class of bacteria doesn’t mean that it will be effective in others. This error in applying a finding to other non-related pathogens or conditions is rampant in discussions about herbal medicine (see my post on Herbs for Ebola). Remember: this information is for a certain preparation in a certain type of experimental model. A may not always translate to B.

  • Is the dose and preparation relevant to what people would actually use?

I can’t stress this enough. Many natural substances can have an effect in test tubes and animals, but getting those amounts in humans would not be feasible. If possible, a critical examination of study doses and concentrations should be part of your research toolkit.

This is the first of a series on botanical research. Please leave your questions and feedback in the comments!

On the Subject of “Herbs for Ebola”

In October there was a torrent of Facebook and blog posts on herbal remedies for treatment of Ebola virus infection. The outbreak has been raging in West Africa for several months. But when the possibility of one on US soil emerged, so did the hysteria. Common suggestions for antiviral treatment by posters on the net included “classic antivirals” like elderberry, lemon balm, St. John’s wort. Elderberry has been studied for influenza A/B, lemon balm with HSV, and hypericin (from St. John’s Wort) has shown some in vitro activity against a few viruses, but when it comes to testing them in humans against Hep-C and HIV infections, effects were nil. Garcinia kola seeds were a popular remedy-turned-meme based on a single 15-year old lab test.

I know there is little harm in these thought experiments of devising treatments for these deadly outbreaks. Similar conversations occurred during the fear of the swine flu pandemic. Is it not better to speculate about protocols than do nothing?

When it comes to terms like herbal antivirals (or herbal antibiotics, etc)–I don’t think this is an a good way to describe the ways in which herbs work. Herbs are chemically complex molecular multitaskers–the polar opposite of single agent pharmaceuticals with a single biological target. Calling something an ‘herbal antiviral’ is cramming a square peg into a round hole and does not play to the strength of herbs either. When you’re holding a hammer, everything looks like a nail. But it behooves a practitioner to be aware and cognizant of the limits of tools and methods. If not, than you’re just a prosletyzer, preaching the endless merits of your chosen practice. Are you a pragmatist or a preacher?

What I take issue with the most is the misinformation clustered around this topic. First, most the information used in the development of these protocols are gleaned from in vitro data. Many substances and phytochemicals exhibit antiviral properties in vitro, and these are usually isolates or concentrated extracts, on organisms in test tubes. This makes extrapolation into a live human body difficult.

My concern is not that herbalists stretch botanical therapeutics and try to come up with something new. Instead, I take issue with the assertion of a ‘remedy’ without consideration or discussion of where the information originated.

My parting words on Herbs for Ebola: critically appraise the origins and habitat of information, and be transparent about it. Always look under the hood, because it’s common for people to stretch or sweep away information.

Exponential Medicine – Recap & Reflections

I just got back from attending the Exponential Medicine (#xMed on Twitter) conference hosted by Singularity University in San Diego. This conference, similar to TEDMED, aims to share innovative ideas and developments in medicine and healthcare. It seeks to answer “what’s next?” in these fields.

The conference and innovation lab was predictably occupied with speakers and companies in the fields of stem cell research, tissue engineering, bioprinting, regeneration, synthetic biology, big data, mobile app technology, AI.

I’m very intrigued on conversations about the future of anything, but most importantly when it comes to medicine or healthcare. These fields are vital for the continued evolution of humanity, and all life on earth. When something becomes ordained as The Future of X, it becomes a self-fulfilling prophecy. We race to get to the future first, chasing the next big thing. So I watch these developments with as much of a critical eye as I can muster, especially attentive to the origins, trajectories, and meanings of these ‘futures’. These innovators rarely, however, examine our past or roots. Or the ecological context in which they are an inextricable part. They can’t. The whole field is too specialized. But how can you assert a future without a global view?

I am not against technological development or advancing medical technology as much as possibly. On the contrary: these technologies can and will save lives and improve quality of life for those who can access it. But I stand as an outsider looking at the greater social context, and wonder.

I did not see anyone questioning the fundamanetal tenets of their field– a practice which could surely expose blind spots or reveal some kind of blue sky for future developments. A couple speakers argued that better access and more meaningful patterns from big data can provide patients and providers with more relevant and actionable knowledge than RCTs–a good point. Data mined from real patients in real situations is more realistic than trial patients, who are often excluded if they have a comorbid condition. (That and I think RCTs testing treatments against placebo is unethical, but that’s another post.) No one, except for Paul Stamets (pictured above), advocated for even a remotely ecological or cross-species view of health. With an increasingly myopic view of heathcare, we lose context and are therefore subject to poorly performing interventions.

These technologies are beautiful. I’m excited for what they can bring. But we may well go even further by flipping the subject and seeking innovation in tradition, examining why we do what we do, how we know what we know. I’d love for medical educational programs conferences to philosophize a bit more with these subjects. I think only then do we fully engage the subject and envision the future we want to create.

And the setting? Lovely.

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Hotel Del Coronado

What Is Botanical Medicine?

Botanical Medicine – also known as Herbalism, or just Herbal Medicine – is the study and practice of safe & sustainable use of herbs for whole-person health, including gathering & use of safe/available plants, basic medicine making & basic nutrition. In the process, we learn more about our environment and the natural world. Read more

The Herbalist’s Chain of Custody

In my practice I often play the role of an ambassador, explaining the thought processes & approaches of a clinical herbalist. One of the ways that makes practicing herbalists distinctive from other professions is the chain of custody of their medicines, and their embedded connection with the living, breathing landscape.

Herbalists occupy & triage the continuum between patient, practice & Earth. This is especially true when they make their own medicines–they oversee and craft a chain of custody. When I supply a formula of marshmallow root & chamomille flowers that have come from my garden, I’m not offering just a product. I’m offering a deep understanding of how those plants grow, evolve, and interact with their environment. In overseeing the craft of that product, it’s not just better quality–we invite a dimension of knowing unique to our practice. We are helping our patients evolve their narrative and understanding. This is an important aspect of the long-term healing process.

It’s as if we have one hand stretching into the landscape; formulating, crafting. And with the other, we can offer another a connection, language and, in some ways, a truth.

Herbal Terminology Demystified: A Bit on Herbal Actions, Energetics & Listening to the Language of the Plants with our Bodies

(For a PDF handout version, see Resources.) Plants are complex, living beings—just as we are. And their interactions with our bodies in the context of healing can begin to be understood in terms of patterns of basic energetics: heating & cooling, drying & moistening.

Photo Nov 24, 10 53 20 AM

Herbal actions describe the observable effects of herbs in the body. Energetics refers to the overall characteristic or quality of an herb— for example, we know cucumbers are cooling and ginger is warming. This language of energetics & actions gives us a way to understand the broad spectrum of plants in a healing context. It also allows us to get creative with plants and determine substitutes when our first choice isn’t available. A number of bitter plants can be used to assist digestion. Similarly, a wide range of antiinflammatories can be called in to relievethe pain & tension associated with certain types of inflammation. Familiarity with the language of herbal actions and energetics opens our senses & imaginations to the plants around us, and ultimately helps deepen our practice with them.

Botanical medicine is an art & a science. And this is the art part. The way plants flow through us can be perceived & described in several ways. Read more

Turkey Tail Mushrooms & The Antifragility of Immunity

This article appeared in the Fall 2013 issue of Plant Healer Magazine, one of this era’s finest publications for plant aficionados.

Medicinal mushrooms have a lot to contribute to an herbalist’s practice. Turkey Tail (Trametes versicolor[1]) is begging to be used, like the little kid persistently raising its hand in the classroom, “Pick me! Pick me! Pick me ppllleeaassee!” This little mushroom–so tenacious, resilient & adaptable–has so much to offer in terms of medicine. Their earthen-colored fan shapes herald the arrival of the rains as they move in and digest dead trees, turning them into soil so new life can sprout. These decomposing fungal organisms (known as primary decomposers) are vital in the cycle of life & the seasons, each one an agent in an autumnal pull back to the earth, doing the good dirty work so new life can leap forward in the next season[2].

Turkey Tail mushrooms are busy little beavers in our ecosystems, aiding decomposition & soil generation. In human & animal bodies, the story changes. They means by which they support immune function are enchanting–providing clever little nudges here & there that invigorate our immune response. They’re ubiquitous in the wild and versatile in combination with other plant medicines. To me, this makes them a key member of the apothecary. Read more

Pseudotsuga menziesii: Windows into Forest Medicine

This was one of 3 trees covered in my Trees, Humans & Healing talk at the 2nd Dandelion Seed Conference in Olympia last weekend. I wrote an expanded piece on Douglas-fir, which may behoove the reader to peruse before or after grazing this post. 

Origins & Ecology 
Douglas-fir is the dominant tree west of the Cascade Mountains and is this continent’s second tallest tree (exceeded only by the Redwoods in the South). It’s found in coastal regions stretching South into the Santa Cruz Mountains up to West Central British Columbia, and East into Northern Idaho and Western Montana.

Douglas-fir is, as a name, a misnomer. It’s not a true fir (which belong to the Abies genus). Its genus, Pseudotsuga, translates to False Hemlock. Other common names it’s had over the years include Oregon Pine, Oregon Spruce, Red Fir. Due to confusion around the name ‘Douglas-fir,’ some botanists have proposed the name ‘Douglasstree’ as comfortably distinct from other conifer common names. It got its name from a Scottish botanist, David Douglas, who conducted a botanical expedition to the Pacific Northwest in 1825. During his tour, he also named a number of other plants: Doug-fir mistletoe, Douglas aster, Douglas gentian, Douglas buckwheat, Douglas onions, and more. Its species name, menziesii, is named after Archibald Menzies, another Scottish naturalist.

Doug-firs migrated to the area at the end of the Wisconsin Ice Age 11,000 years ago when the climate transitioned from subarctic to temperate. This brought mild/wet winters & dry summers to the West—conditions which favor conifers. The first species to migrate North was Lodgepole pine. And as the area warmed, Douglas-fir began to enter the landscape.

This tree has a special relationship with fire. The seedlings are shade intolerant and require sunlight penetration through the canopy to grow. Forest fires that clear out the understory/deadwood are necessary for them to proliferate. (This also happens when an area is logged. In fact, the logging practices of the last 200 years created artificial disturbances that enabled Douglas-firs to thrive.) Doug-firs possess thicker bark and a faster growth rate than most climax trees of the area (such as Western Hemlock and Western Red Cedar). This quality gives Douglas-firs a competitive advantage when the forest experiences a major disturbance such as fire. Read more