Ashwagandha Could Offer Knee Pain Intervention Alternative

Ashwagandha, a powerful herb used in Indian Ayurvedic medicine, is known for its immune-boosting and restorative benefits. In fact, it’s commonly referred to as “Indian ginseng” and has been used since ancient times to help people strengthen their immune system after an illness.  A new study conducted on Natreon’s ashwagandha extract, Sensoril, shows that they herb could also affect joint health and relieve knee pain, according to a report published in the Journal of Ayurvedic and Integrative Medicine.

The study began in India when researchers from Nizam’s Institute of Medical Sciences in Hyderabad conducted a randomized, double-blind, placebo-controlled experiment on 60 subjects with a mean age of 58 years old who suffered from knee pain. The subjects consisted of 43 males and 17 females, who were divided into three groups to take either a placebo or one of two Sensoril capsules, 125 or 250 milligrams, twice daily. The effects of the intervention were measured against baseline values at four, eight, and twelve weeks using Modified Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Swelling Index (KSI), and Visual Analogue Scale (VAS) scores.

Researchers found that both doses of the ashwagandha extract produced a significant reduction in new pain symptoms, with the higher dose group showing a significantly better response. The therapeutic response appears to be dose dependent and free of any significant gastrointestinal disturbances, according to researchers.

The capsule’s effects are the result of bioactive within the botanical, according to Dr. Aparna Kalidindi, Pharm D, manager of technical sales and marketing at Natreon. The main bioactive, Withanolide glycosides, have a significant effect on the hypothalamic-pituitary-adrenal axis, which regulates serum cortisol concentrations. Sensoril reduces serum cortisol levels, resulting in improvements in symptoms of chronic stress. In addition, the anti-inflammatory effects have been attributed to its Withaferin A and its antioxidant activity.

Ashwagandha offers a vegan alternative to many mainstream joint pain medications, which often come from animal sources. Researchers say it will be difficult to compare the two treatments side-by-side, though, due to different dosages and frequency of dosages.

In addition to joint health and healthy aging positioning, the new study could open opportunities for ashwagandha use in sports nutrition and medicine. The data currently pertains to an older individual already suffering from knee pain symptoms, but researchers say the treatment could work on knee pain in younger, active individuals and athletes.

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The Immune System: Anatomy & Physiology

The immune system serves as the body’s greatest defense mechanism against foreign invaders. But as herbalists, we see it as much more than just a systematic fortress.  Medical herbalist Diana Jones writes, “Immunity represents an ecological interface between inner and outer environments”–a concept that considers immune health holistically, linking it to our relationship with mind, body, spirit and ultimately our largest bodily ecosystem—nature. Our “Herbalism, Anatomy & Physiology” series continues with an overview of how this complex system works, as well as some herbal tools to keep your immune system healthy.

Technically speaking, there are two forms of immunity: innate immunity (non-specific) and adaptive immunity (acquired).  The innate immune system functions with what we were born with, our genetic predispositions of self-protection. It’s the first line of defense, including our skin, the tissue lining of our respiratory and digestive systems, our mucous, chemicals in the blood and immune system cells. When it senses the chemical properties of an antigen, a.k.a. our foreign invader, the innate immune system kicks into gear. Adaptive immunity, on the other hand, functions differently and serves as the inspiration behind modern-day vaccines. This form of immunity actually holds memories of antigens it has fought before, so it generates a more efficient response when encountering future attacks. While these two forms of immunity are considered the foundations of our immune response, there are other key players and body systems.

The Immune Alliance

Lymphatic System
While it’s natural to think of the immune system as a stand-alone entity, our lymphatic system also plays an important role in keeping us well. Perhaps this is why so many ancient medicine practices, like Ayurveda, emphasize lymphatic support through the use of herbs and massage for self-care. This commonly forgotten network system touches almost every part of our body system. It’s comprised of key organs and lymph nodes and transports lymph fluid, carrying critical immune cells throughout the body, as well as digested fats, fat soluble vitamins, and more. To support your lymphatic health, try dry brushing regularly or consider using alterative herbs like cleavers and burdock.

White Blood Cells
Created in the bone marrow and stored in the blood and lymphatic system, these cells are essential for supporting immunity and fighting infections. Unlike other cells, white blood cells do not have nuclei. Since these cells only live for one to three days, your body is constantly reproducing them and helping to regenerate itself regularly.

Spleen
Considered the largest organ in the lymphatic system, the spleen mostly acts as a blood filter and a storage system. It also helps to slow blood down and give the immune system time to create antibodies to fight antigens. While you can live without one, it would certainly create a higher risk for infections.

Bone Marrow
This spongy tissue resides inside your bones and produces blood cells, including platelets which help with clotting and white blood cells which fight infection.

Thymus
This organ is part of the lymphatic system which produces T cells, or lymphocytes, which help the adaptive immune system respond to antigens.

Support Immune Health

The beauty of herbal formulation is that it can be uniquely tailored to each person’s needs. A herbalist may not only use immune herbs for seasonal support, but alteratives to support the lymphatic system, diaphoretics to support a healthy sweat, nervines to reduce stress, or whatever herbal allies are calling to the herbal practitioner and client. By supporting the body as a whole, we believe we have a better chance of being and staying well. Below are some herbs that are used traditionally when thinking about immune support.

Echinacea (Echinacea purpurea, Echinacea Angustifolia): Once you taste echinacea’s powerful root, you’ll be surprised by the tingling sensation that soon follows. One of the plant’s distinguishing characteristics is the presence of alkylamines, which help to stimulate the immune system and provide a powerful boost.

Elderberry (Sambucus nigra): Traditionally both the flowers and berries of the black elderberry tree are used to support the immune system in the depths of winter.* European apothecaries often have the dark purple syrup handy to aid in seasonal wellness.

Thyme (Thymus vulgaris): Because this kitchen herb is rich in the volatile oil thymol, it’s commonly used in cough drops, mouthwash, and ointments. A soothing plant ally for winter.

Licorice (Glycyrrhiza glabra): It’s not just for pacifying a sweet tooth; this root also aids the respiratory system in times of need. Whether you’ve sung yourself hoarse or your throat is trying to tell you something.

Ginger (Zingiber officinale): While you may know this rhizome for its digestive supporting properties, it’s also known for seasonal support in traditional herbalism. If you drink enough ginger in your tea, it will act as a warming agent, helping the body “sweat it out.”

Adaptogens: A classification for herbs that provide deep immune and whole body support, and they also help the body adapt to stress. Many of these herbs are immunomodulators, like astragalus (Astragalus membranaceus), reishi (Ganoderma lucidum), codonopsis (Codonopsis pilosula), and schisandra (Schisandra chinensis).

Our herbalists see immunity as the web, intricately woven between other key body systems and gut health. Many practitioners have witnessed the undeniable correlation between strong immune systems and a healthy outlook on life. While we believe the immune system to be more complex and powerful than one can even fathom, we are certain that happiness, living in communion with nature, having healthy relationships, and embracing plant medicine certainly can help.

Echinacea 101

If you taste echinacea’s powerful root, you’ll be surprised by the tingling sensation that soon follows. While many herbalists enjoy echinacea’s root, the entire plant can be used for its immune boosting properties.* The alkyamides in echinacea help stimulate the immune system, but this is only one set of constituents that work in harmony with many others in the plant. Perhaps this is why it is one of the most studied plants in Western herbalism. The true identity of all the active principles still remains open, making echinacea’s true powers another plant mystery!

All the plants in the echinacea genus are indigenous to North America and originally dwelled in prairie lands. In the mid-1800s, the American Eclectic physicians began to use echinacea and its healing powers reached beyond the New World.  By the beginning of the 20th century, it was one of the most frequently used herbal preparations in the United States, and overharvesting of the wild perennial flower soon followed.

Fortunately, United Plant Savers works to restore native populations of plants, and echinacea can now be cultivated in many different regions of the world. The best way to start your echinacea seeds is to have them endure a period of cold, moist stratification. What’s that, you ask? Some seeds are very hardy and lay dormant until awakened by the cold weather. Stratification either stimulates or creates winter conditions to encourage germination or sprouting. In the wild, echinacea’s dormancy is naturally overcome by spending time in the ground and enduring long winters.

The easiest way to start echinacea at home is to sow echinacea seeds about ¼ inch deep in fall, cover with a thin layer of rich compost and let nature take its course over the winter. Another option is to place the seeds in a small jar with some sawdust, vermiculite or peat moss. Then moisten and place the jar in the refrigerator for about a month. Once spring arrives, the seeds can be planted a ¼ inch deep into a large pot or directly into the soil. These purple coneflowers enjoy partial to full sun, ample water (but can handle some drought) and good drainage. You can expect the perennial to bloom fully by the summer of its second year.

tradmed_bp_november_embed_echinacea101_04-webThe leaves of Echinacea purpurea sometimes have “covering trichomes,” which are hairs, emerging right from the skin (or epidermis) of the leaf. Our microscopist helps to identify plants and saves photos like the above to deepen our knowledge of key plant identification features.

If you think you have found this plant in the wild, you will be able to identify it by some of its most pronounced features. All members of the Echinacea genus are perennials that bloom with both disk and ray flowers. The purple ray flowers attach to a round, high and spiky cone – hence the common name “purple coneflower.” Technically speaking, this thick and spiky cone is actually hundreds of more flowers, all tightly packed together.

So when you’re feeling like you need a plant ally to give you a boost, think of echinacea.

Now when you see a beautiful echinacea flower while you are out and about, its radiant purple flowers and sturdy structure will remind you of just how powerful this plant really is.

echinacea02Cold Stratification of Seeds for Growing Echinacea Purpurea

Attract goldfinches and butterflies to your garden with a healthy stand of Echinacea purpurea, or purple coneflower. The plant is a native perennial that thrives in U.S. Department of Agriculture plant hardiness zones 3 through 9. Purple coneflower grows from 2 to 4 feet tall, depending on variety, producing purple petals around a cone-shaped center in late summer that first draws butterflies, then finches as it becomes a bristly seed head. Once established, the plant is easy to care and readily self-seeds in place. When starting purple coneflower from seed indoors, you’ll get the best germination rates if seeds are cold stratified.

Cold Stratification

Cold stratification is a seed treatment developed to help gardeners mimic the winter conditions many seeds need to break dormancy and germinate. Many plants, both perennial and annual, that grow in a cold-winter climate evolved winter seed dormancy to keep them from sprouting when conditions are too cold or dry for sprouts to survive outdoors. Some seeds need only dry stratification — exposure only to temperatures between 33 and 50 degrees Fahrenheit — to germinate, while others need moisture in addition to the cold treatment. The length of stratification required also varies by plant species.

Purple Coneflower Stratification

Purple coneflower seed germinates best with moist stratification. Mixing the seeds with a small amount of sawdust, vermiculite or peat moss inside a plastic zipper bag or small jar for cold stratification keeps the seeds moist without hindering germination later. Seeds are sown one-quarter inch deep in containers of moist potting soil and covered with plastic to retain moisture. These containers go inside a refrigerator or other area where the temperature is consistently between 33 and 60 F for the entire stratification period. The temperature experts specifically recommend for E. purpurea coneflowers varies from 40 through 59 F, with the majority at the lower end of the range. Gardeners in areas with winter temperatures consistently in this range can place trays outdoors. Packaged seed often is pre-stratified and does not require any chilling to germinate.

Timing Stratification

The time required for stratification to be effective varies as well, from as little as two weeks up to a month for the seed to break dormancy. Planning for four weeks of cold prevents any question, as chilling for too long is not harmful to the seeds. Stratification time should be figured into your propagation time so that seeds are removed from chilling when it is time to sow. Seeds germinate in 10 to 30 days at 65 to 70 F and are often ready for transplanting within 30 days. The higher the temperature for both the seed and the seedling, the faster the germination and early growth. Purple coneflowers prefer slightly cool temperatures as seedlings and can be planted out just after the last predicted frost. Stems may be stronger and develop more flower buds when they experience cool temperatures of about 40 F after planting out.

Growing Purple Coneflower

Purple coneflowers grow in full sun to partial shade — dappled shade is ideal — in pH neutral, well-drained soil. Plants started from seed may not bloom for two years after planting. Transplants need at least 15 inches between them for the air circulation necessary to avoid disease, but no more than 24 inches to avoid spindly growth that requires staking. They are drought tolerant once established, but low to moderate water throughout the summer results in the prettiest plants. Like most natives, coneflowers have low fertilizer requirements, although a slow-release, high nitrogen fertilizer, like a 12-6-6, is beneficial in early spring as new growth begins. Deadheading keeps the plant blooming and compact and prevents self-seeding. Basal foliage is evergreen in zone 9 but can be cut back in early spring if it needs to be refreshed.