Interview by Craig Gustafson
In part 1, Dr Kamhi discussed the connection of the HPA axis to the gut, described how critical pineal- and thyroid-gland function is to the HPA axis, and named some herbs that provide support. In part 2, she discusses how to use these herbs to support the HPA axis.
Alternative Therapies in Health and Medicine (ATHM): Let’s talk about fenugreek, spearmint, and fennel seeds. What forms of these herbs work well for promoting melatonin production? Are we talking tinctures? Are we talking teas? Sprinkling them onto foods?
Dr Kamhi: The answer is actually all of the above. You can use fenugreek seeds in food, take capsules, or use it as a liquid extract. Each method will offer a different dose, so refer to the product label. A usual dose of fenugreek would be 1000 milligrams per day, or approximately 1 gram.
ATHM: How about spearmint? Are you just talking about a mint tea?
Dr Kamhi: Mint is well known traditionally as an herb that helps to soothe digestion. It also has antimicrobial effects, which are fantastic when talking about that gut-brain barrier interference we discussed earlier in terms of the implications of dysbiosis.
These really simple traditional remedies are wonderful, especially when considering the low incidence of adverse effects, unless someone has an allergy. Spearmint effects include antimicrobial action, relaxation, stress reduction, and reduced cortisol. These herbs also supply natural amino acids that may help support serotonin production within the body. Just drink a good-quality tea or grow your own and pick it yourself!
ATHM: With fennel seed, I would imagine that most often you would be sprinkling that into food. I know they are usually a component in sausage; that is where I run into it most often.
Dr Kamhi: You may also encounter fennel seeds when leaving an Indian restaurant. They usually have fennel seeds as you walk out as a little treat. That is a traditional ethnic practice gleaned from Ayurvedic medicine. At the time that practice was developed, they did not have a chemistry laboratory to investigate the active constituents and know all the nutritional components that are naturally occurring in fennel seeds. We know now that this herb also helps to destroy harmful bacteria.
As is so often the case with ancient traditional remedies, they did not have our modern language such as “gut-brain connection,” nor were they able to evaluate the fact that fennel seeds contain numerous flavonoid antioxidants, such as quercetin. However, they used fennel to help health issues, which we now understand may be linked to leaky gut. In addition, fennel is a very rich source of fiber and contains volatile compounds such as limonene and pinene.
Whenever we review old-fashioned, traditional remedies such as the Ayurvedic tradition of eating fennel seeds at the end of a meal, we often see that when we bring modern science into the mix and look at the mechanism of action of these ancient traditions, we can begin to appreciate why they work.
Fennel seeds can be chewed or taken as a tea or as an herbal extract to help relieve gas and indigestion. They have a very good safety profile. Of course, anything could be toxic in very high concentrations or if someone has a particular sensitivity.
ATHM: You said you had some other herbs you wanted to talk about.
Dr Kamhi: I would like to mention a few herbs that are less well known, which offer a myriad of positive effects as natural remedies to help regulate circadian rhythms, affect sleep balance, decrease overrelease of cortisol, and bring down the inflammatory compound nuclear factor kappa B. Chronic inflammation, of course, has everything to do with all chronic illness, so it is really one big picture.
One herb that is very interesting is Cordyceps. Cordyceps is actually a fungus that grows out of worms. Its name in Chinese translates to “winter worm-summer grass,” which reflects this transformation. Newer varieties are being grown on nutritional yeast, which makes that variety of Cordyceps acceptable to vegans. Evidence-based, proven effects of Cordyceps include antitumor action, immunomodulation, inflammation reduction, and the reduction of cortisol.
In ancient times, Cordyceps was used by emperors and wealthy royal families. It was treasured like gold and only the rich and famous could use it. Now, of course, it is a lot more widely available.
Cordycepin is one of the active constituents contained in Cordyceps that has been widely researched. It is an inflammatory inhibitor, modulates kinase, and slows detrimental aggressive reactions in connective tissue that lead to joint damage in arthritis.
Cordyceps interferes with the cytokine pathway that is initiated by stress. Usual dosage is 3 to 9 grams per day, used as a liquid or powdered extract. It is generally considered safe. It has been used for thousands of years with very few reports of any toxic side effects.
ATHM: When you say 3 to 9 grams, are you referring to Cordyceps mushrooms or the cordycepin?
Dr Kamhi: Three to 9 grams would refer to the full mushroom ground up. The dosage would be lower if you are getting a standardized product where one active constituent is extracted. It may have a more targeted effect, but sometimes, by using standardized herbs prepared by extracting one active rather than just measuring and assuring a specific amount of an active, you may lose the complementary modulation of the other naturally occurring components.
That is what pharmaceutical drug therapy often does. It extracts out one active constituent, concentrates it, and administers it in a targeted manner. This is often the cause of a wide range of adverse effects.
ATHM: It sounds similar to extracting the cannabinoids in Cannabis, and not having the terpenes available, or some of the other synergistic molecules that also work with and help to regulate their action on the body.
Dr Kamhi: That is exactly right. I have been practicing herbal medicine since 1964, and I am a traditional herbalist, but I also study and teach botanical pharmacognosy. When the standardization concept arose in the 1990s—I actually was not a big fan of it. However, for anyone seriously involved in marketing herbal medicine, it became imperative to incorporate standardized products, because consumers wanted it and physicians requested it. In addition, I have learned over time that there are actually some really good pieces of information that can be gleaned via the concepts of standardization, such as getting a higher-level, reproducible targeted effect.
Also, standardization allows growers to fine-tune growing and harvesting practices that will naturally yield the highest amount of active constituents. Examples include harvesting in the morning versus at night or before or after a rain.
When you look at a bottle of herbs and it says standardized, you actually do not know which method of standardization has been used. Has the whole plant been harvested and just measured for a particular active, such as echinacosides in Echinacea, or was a single chemical extracted and put directly in the capsule? Both methods will simply say standardized on the label.
ATHM: So there is no way to tell?
Dr Kamhi: You can call the company and ask, but there is often no other way to tell.
ATHM: In your practice, do you prefer the former?
Dr Kamhi: Yes, in my opinion there is a lot to be said for getting plant medicine as close to nature as possible. In fact, I actually take people out into the field to wildcraft, or gather our own plants and make them into medicine. In this situation, there is no standardization or measuring of actives, but there is the immeasurable energetic interaction between the person and the plant. That is actually my favorite way to use herbal medicine, but that is only for the few who are interested in participating in their own health to that extent.
In part 3, Dr Kamhi discusses some lesser-known herbs that are often overlooked but offer potent options for supporting the HPA axis.