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The Ayurvedic Approach to Mental Illness

By Renata Trister, DO


The Ayurvedic Approach to Mental Illness

Mental dysfunction is pervasive in our society, manifesting from mild loss of memory or lack of concentration to severe disabilities such as Alzheimer’s disease. Virtually everyone is touched directly or indirectly by mental dysfunction, imparting a serious impact on our personal health. Ayurveda uses revitalizing, balancing and nourishing herbs that have a long history of traditional use in improving mental function, such as gotu kola (centella asiatica) and brahmi (bacopa monniera). Some of these herbs are currently being investigated phytochemically to better understand their actions.

 Mental dysfunction

The problems associated with mental dysfunction such as loss of memory, Alzheimer’s disease, loss of clarity or acuity and other related conditions are very common. For example more than four million Americans has this debilitating disease, with the number expected to reach 14 million by the year 2040.

Those who are at greater risk for mental dysfunction include the elderly, the young with inherited or acquired disabilities, those who engage in highly stressful activities, those with diseases, and anyone exposed to toxic chemicals or lack of oxygen. Considering this, everyone is at risk to some degree at some time in his or her life. Whether suffering from “mental fog” or the early symptoms of a more serious problem, nearly everyone can benefit from a daily revitalization of mental function.

According to Ayurveda, an imbalance causing mental dysfunction is related to individual “doshas” or the elements of Vata, Pitta, or Kapha (air, fire or water). For example, a disturbance in Vata may contribute to poor memory, nervousness. Imbalances that may contribute to mental dysfunction are often related to Vata dosha, but may also be related to Pitta and Kapha dosha, which could dominate an imbalance. The element Vata is related to the control of the nervous system and the processes of intuition, nerve force, short term memory, intellectual concepts, mental dexterity, depression, insomnia, anxiety, attention deficit, hyperactivity, fear, loss of short term memory and over-sensitivity. Vata is also associated with kinetic movement in general, including nerve impulse movement, peristaltic motion, tissue growth movements, and other physiological motions.

Kapha is solid, liquid, inertial and organizing. Kapha may be associated with certain mental qualities such as deep intelligence, love, long term memory, steady emotions, loss of long term memory, deep depression, sadness, despair, resentment, sluggishness and slowness. Pitta may be related to certain mental qualities such as joy, happiness, enthusiasm, creativity, sharpness, intellectual discrimination, anger, rage, jealousy, irritability and hatred. The Ayurvedic approach for a condition such as mental dysfunction is to treat the whole person, including application of correct diet, lifestyle recommendations, and herbal supplements. Based on traditional use, Ayurvedic herbal formulas may be used to address specific individual health conditions with traditional herbs that are known to balance, or ameliorate an imbalance, and thereby improve health.

Medhya — Prominent Ayurvedic mental revitalizers

The traditional Ayurvedic herbs recommended for mental conditions are mainly mental revitalizers or Medhya (brain tonics), which are known to enhance general mental functioning. Specific Medhya herbs include bacopa (bacopa monnieria), gotu kola (centella asiatica) and ashwagandha (withania somnifera).


Bacopa, or brahmi, is a famous Ayurvedic mental revitalizing herb used traditionally for memory, insomnia, epilepsy, insanity and as a mild sedative.6 It is tridoshic, or balancing, for all body types. There is a connection of the name of the herb and its use for the mind. The name brahmi comes from the word Brahma, which is a name for the creator of the universe. Brahma is credited as manifesting his thoughts as the creation and everything is a manifestation from the mind of Brahma. If there was only one choice of Ayurvedic herb for general mental function revitalization it would probably be bacopa. There is a legend that describes bacopa as a favorite food of elephants, animals known for their long memories. It may be a favorite food of elephants because they are slow and dominated by Kapha and tend toward inertia, so they need to eat bacopa to be more alert and mentally revitalized. In any case, bacopa has been known for centuries as a common and popular Ayurvedic herb for general mental revitalization.

Contemporary phytochemical research has revealed evidence that bacopa acts as a potent antioxidant in inhibiting lipid peroxidation, which could be one of the reasons why it acts as a good mental revitalizer.6 Antioxidants have been linked to improved brain and nervous system function. Studies on the effect of the active constituents (bacosides) of bacopa on the mental retention capacity of rats have shown that the herb has a facilitatory effect on acquisition, consolidation and retention of newly acquired behaviors in response to both positive and negative reinforcement.

Gotu kola

The Ayurvedic herb, gotu kola, is used traditionally as a brain tonic for improving memory and intelligence, for mental stability, and as a sedative. Numerous animal studies have been conducted to evaluate the influence of the gotu kola leaf extract on the central nervous system. The studies demonstrate that the extract produces anxiolytic (anti-anxiety), sedative, and antidepressant effects comparable to the drugs, diazepam and imipramine, without any apparent toxicity.


Ashwagandha is used extensively in the Ayurvedic system of medicine to promote health and longevity by arresting the aging process, revitalizing the body, promoting memory and intellect and reducing stress.

The likely active principles of ashwagandha appear to be withanolides. The antioxidant activity of these active principles have been investigated on rat brain concentrations of the free radical scavenging enzymes superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX). Active withanolides administered once daily (10 and 20 milligrams per kilograms) for 21 days induced a dose-related increase in SOD, CAT and GPX activity in the frontal cortex and striatum, areas highly susceptible to oxidative damage. This antioxidant effect may explain, at least in part, the reported anti-stress, cognition facilitating and anti-aging effects of ashwagandha.

Ayurveda: A holistic approach

The tradition of Ayurveda offers some explanations for the function of mentally revitalizing herbs and their effects. The following sections will address how 1) balancing the constitutional elements can improve mental function, 2) how directly nourishing a tissue system or dhatu can improve mental function and 3) how improving digestion can enhance mental function.

Balance of the doshas and mental function

Balancing the doshas or elements in the body can improve mental function. For example, if the water element or Kapha dosha is over accumulated in the body it may create an imbalance that develops excess inertia, leading to an experience of mental sluggishness or dullness. An herb that may help to balance this condition by reducing the water element and increasing the air and fire elements, thereby creating balance and improving mental clarity, is nutmeg (myristica fragrans). Another example is the imbalance caused by an excess of the air element, or Vata dosha, which can affect memory and cause nervousness. Ashwagandha is another herb that helps to balance this condition by reducing the air element and increasing the water element, thereby bringing about balance and improving memory.

Triphala, a combination of three herbs including amla fruit (emblica officinalis), Indian gall fruit (terminalia chebula) and beleric myrobalan fruit (terminalia belerica), is known to encourage a general balancing of the doshas in all body types. An improvement in the general balancing of the elements in the individual as a whole can improve mental function along with other physiological functions, because in the Ayurvedic approach optimal balance is equivalent to optimal health. If the mental dysfunction is associated with an imbalance due to the over accumulation of Pitta dosha in the body, then cooling and anti-Pitta herbs such as amla fruit, asparagus (asparagus racemosus) and heart-leaved moonseed (tinospora cordifolia) may be given to balance the condition and improve mental function.

Mental revitalization and nourishment of the dhatu

Mental function may be improved by directly nourishing the bone marrow tissue system or Maiji dhatu to revitalize that tissue system. For example, if the brain and nervous system are fatigued from stress and over work, herbs such as bacopa, gotu kola, ashwagandha, asparagus, heart-leaved moonseed and giant potato root (pueraria tuberosa) may be used to directly nourish the Maiji dhatu or the bone marrow, brain, and nervous tissue system. Because Maiji dhatu comprises the brain and related nervous system, when it becomes nourished, it is revitalized and this revitalization enhances associated mental function.

Improving digestion and mental discrimination

Discrimination and digestion are both controlled by agni or fire which is related to Pitta, or the fire element. According to Ayurveda, poor digestion can negatively affect mental discrimination because mental discrimination and digestive discrimination are directly related. As an example, eating toxic foods may cause indigestion interfering with the digestive system’s ability to discriminate between what foods should and should not be processed for digestion. This may lead to headache or mental sluggishness, disabling clear intellectual discrimination. By improving digestion, digestive discrimination and mental discrimination can be improved. For the purpose of improving digestion, herbs such as ginger (zingiber officinale), Triphala (amla fruit, beleric myrobalan fruit, and Indian gall fruit), nutmeg, cardamom seed (elettaria cardamomum) and asparagus may be applied.

Ayurvedic herbs and contemporary science

Current phytochemical research demonstrates some links between a number of the Ayurvedic herbs used for enhancement of mental function and the respective biochemical basis for their effectiveness. For example, ginger has been shown to possess strong antioxidant activity, anti-inflammatory properties and digestive-promoting qualities that may protect brain and nerve tissue from free radical damage.  Amla fruit is known to be an antioxidant herb naturally high in vitamin C.  As another example, nutmeg acts as a smooth muscle relaxant and offers a sedative action.  It is generally known that a sedative action can produce a palliative effect on the brain and nervous system related to nervous mental conditions. It is believed that Indian valerian (valariana wallichi) may also have a sedative action.  A traditional Ayurvedic mixture focused on harmonizing gut, brain, muscle, and nervous system functions resembles a contemporary strategy for managing mental dysfunction — control the production of inflammatory prostaglandins, protect sensitive neurological tissue from free radical damage, improve digestion and assimilation to ensure optimal nutrition and improve circulation by controlling platelet aggregation.

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Musculoskeletal Healing Supplements: A Summary

By Renata Trister, DO


Musculoskeletal Healing Supplements: A Summary

When injury to a ligament or tendon occurs, a sequence of events begins that initiates healing. The healing process involves inflammation, repair, and remodeling. Research suggests that modulation of these events can be achieved nutritionally, to speed up tissue healing and recovery time.

The Inflammatory Response

Inflammation is in fact a protective and restorative response to injury. However, when inflammation becomes excessive or prolonged it may be harmful to the body. The classic signs of inflammation local redness, swelling, heat, pain, and loss of function are caused and regulated by the activity of a large number of chemical mediators, including eicosanoids.

Eicosanoids There are anti-inflammatory eicosanoids and inflammatory eicosanoids. The standard American diet promotes the production of those that are inflammatory. Fortunately, many substances inhibit inflammatory eicosanoids or promote the production of anti-inflammatory eicosanoids a classic mechanism for controlling inflammation.

Nutrients & Herbs That Modulate the Inflammatory Response

Essential Fatty Acids Omega-3 fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are precursors of primarily anti-inflammatory eicosanoids. In addition, the omega-6 fatty acid, gamma-linoleic acid (GLA), also supports the production of anti-inflammatory eicosanoids.

Ginger (Zingiber officinale) and Turmeric (Curcuma longa) These herbs have long been used in folk medicine for a variety of both acute and chronic inflammatory conditions. Studies suggest that both herbs may block activity of the enzymes cyclooxygenase and lipoxygenase. These enzymes are necessary for the production of inflammatory eicosanoids.

Cayenne Pepper (Capsicum annuum) Capsaicin, the main constituent of cayenne pepper, may play a role in inhibiting inflammatory eicosanoid synthesis by blocking cyclooxygenase activity.   Capsaicin may also reduce tissue sensitivity by selectively depleting a neuropeptide needed to transmit pain impulses to the central nervous system.

Boswellia Boswellia gum resin, derived from the Boswellia serrata tree, is a traditional Ayurvedic remedy used for inflammation. Boswellic acids, the main constituents of the gum resin, have been found to specifically inhibit 5-lipoxygenase. Preliminary research also suggests that boswellic acids may inhibit the complement system—a part of the immune system whose sustained activation is implicated in a variety of inflammatory disorders.

Bioflavonoids Bioflavonoids, such as quercetin, are an extensive group of compounds present throughout the plant kingdom.  Their roles in addressing injury, pain, and inflammation include antioxidant activity and protection of connective tissues, inhibition of enzymes involved in inflammatory eicosanoid production, and inhibition of cell movement to the site of inflammation.

Proteolytic Enzymes The anti-inflammatory effects of proteolytic enzymes, flavonoids, and vitamin C in comparison to NSAIDs

The term “proteolytic” refers to the group of enzymes that break down proteins. In the body, proteolytic enzymes including trypsin, chymotrypsin, bromelain, and pancreatin are produced in the pancreas. Because numerous studies have revealed their wide ranging benefits, these enzymes are available in supplemental form.

According to Dr. J.P. Tarayre and Dr. H. Lauressergues in Drug Research, “The proteolytic enzymes, trypsin and chymotrypsin in particular, possess anti-inflammatory properties which have been known for some years now.” Additional research has demonstrated the ability of proteolytic enzymes to accelerate recovery after minor injury and reduce the pain and stiffness that often accompany rheumatoid arthritis.

To further confirm these findings, researchers compared the anti-inflammatory effects of trypsin and chymotrypsin to seven well known non-steroidal anti-inflammatory drugs (NSAIDs). The proteolytic enzymes were combined with flavonoids and vitamin C other substances known to reduce inflammation.

Researchers injected carrageenan a seaweed extract that has been shown to induce inflammation and edema in the hind paw of experimental rats. After determining the degree of inflammation and swelling in each animal, researchers examined the anti-inflammatory effects of trypsin and chymotrypsin combined with flavonoids and vitamin C.

Researchers concluded that “The combination studied…shows a more [profound] action than that of the non-steroidal anti-inflammatory substances [without] any side effects.”


Nutrients Involved in Connective Tissue Repair

Controlling inflammation is directly linked to the next phase of the healing process repair and remodeling. Following connective tissue injury, it is critical to supply the raw materials and proper nutrients that support tissue recovery and new tissue synthesis. These include:

Amino Acids Supplying amino acids may support the formation of collagen a critical connective tissue. Collagen fibers are made up of long chains of amino acids, of which one-third is glycine. Proline, hydroxyproline, and hydroxylysine are also prevalent.

Bioflavonoids Bioflavonoids are thought to benefit connective tissue by preventing the degradation of elastic  fibers via inhibition of enzymes released as a result of inflammation.

Glucosamine and Chondroitin Sulfate Glucosamine and chondroitin sulfate are building materials that are vital for the synthesis of new connective tissue as well as for the healing process. In addition, supplemental use in those with arthritis has been reported to result in decreased pain and inflammation.

Antioxidants It is thought that excessive free radical production is a major consequence of the inflammatory response—may aggravate an injury, propagate the inflammatory process, and delay or prevent adequate healing. Vitamins E and C are major antioxidants that quench free radicals in most tissues. Additionally, vitamin C is required for collagen fiber synthesis, a vital process for tissue repair and healing. Copper, zinc, and manganese further protect tissues by supporting the activity of superoxide dismutase—an enzyme that converts damaging superoxide free radicals into less harmful molecules.

Effects of copper supplementation in rheumatoid arthritis patients

Copper is an essential trace mineral that may facilitate the activity of ceruloplasmin and copper-zinc superoxide dismutase. These compounds have antioxidant and anti-inflammatory properties that may prevent the onset of chronic joint conditions.

However, according to Dr. Robert DiSilvestro and colleagues in the Journal of the American College of Nutrition, “Several surveys have shown that copper consumption of many Americans falls below even the Estimated Safe and Adequate Daily Dietary Intake recommended for healthy people…”

Copper deficiency can be caused by anemia, protein malnutrition, and frequent diarrhea. A deficiency in copper resulting in reduced activity of ceruloplasmin and copper-zinc superoxide dismutase may be associated with the onset and continuation of rheumatoid arthritis. In fact, it has been shown that patients diagnosed with rheumatoid arthritis show serious copper deficiencies.

Investigators conducted a study in which 23 rheumatoid arthritis patients received 2 mg per day of copper supplementation for 4 weeks. As a means of comparison, investigators also recruited 47 healthy volunteers. Upon completion of the study, investigators noted that copper supplementation increased copper-zinc superoxide dismutase activities by 21% in 18 of the 23 rheumatoid arthritis patients.

Homeopathic Remedies

Homeopathic remedies for injury have been used for over 100 years. Believed to provide an “energetic” stimulus to the natural healing qualities of the body, homeopathic remedies are reported to be highly effective and safe.

Muscle Mechanics, Relaxation, and Rest

Proper muscle use, joint alignment, and biomechanics during tissue remodeling are critical for preventing reduced range of motion due to scar tissue formation. In addition, injury can give rise to increased anxiety, stress, and poor sleep, resulting in prolonged and unfavorable healing. Calcium, magnesium, and various herbs, including passion flower, valerian root, hops and kava root, promote relaxation of the muscles and help to reduce the psychological anxiety and stress resulting from injury.


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Herbal Antimicrobials

By Renata Trister DO



Bacterial Infections and Ayurvedic Botanicals


Bacteria are a natural, and necessary, part of life. These microscopic, single-cell entities abound on inanimate surfaces and on parts of the body that make contact with the outer world, including the skin, the mucous membranes and the lining of the intestinal tract. While we live in harmony with most bacteria, and indeed rely upon many bacteria for their beneficial properties, certain pathogenic bacteria do give rise to serious, often deadly, diseases. Since the advent of the antibiotic era in the early 1940s with the clinical use of penicillin, an ever-growing arsenal of antibiotics has provided an effective therapy against major bacterial pathogens. However, the development of antibiotic resistance is now a serious worldwide problem, caused primarily by the misuse and overuse of antibiotics. We must broaden our view of how to prevent and treat microbial infections to include alternatives that are not centered upon standard antibiotic therapy or we risk the possibility of eventually having no defense against these microbes. The Ayurvedic approach to the prevention and treatment of microbial infection recognizes the emergency use of modern drugs, but recommends traditional herbal combinations and extracts known to balance the individual and improve health, as well as herbs that help to combat or prevent microbial infections. The Indian plants possessing significant anti-microbial activity are Indian lilac or neem (azadirachta indica), long pepper fruit (piper longum), heart-leaved moonseed stem (tinospora cordifolia) and amla fruit (emblica officinalis), among others.


An Ayurvedic approach to microbial infections

Western allopathic medicine emphasizes the use of antibiotics and other medicines and approaches to defend against “germs” or microbes believed to be the primary cause of many health conditions and diseases. Ayurveda recognizes the microbial approach to some degree, but generally does not recognize microbes as the primary cause of disease. According to the Ayurvedic approach, anyone who has developed an imbalance in their bodily elements, or “doshas,” and has thereby weakened their immune system, may be subject to a microbial infection which is considered a symptom of that imbalance. Ayurveda recognizes as useful anything that will save the patient in an emergency, including antibiotics, but takes exception to the “magic bullet” approach of preventing and treating microbial infections strictly with antibiotics. Ayurveda recommends that balance be established in the individual for the prevention and treatment of microbial infection.

From the Ayurvedic perspective, an individual who is balanced and healthy has a strong immune system and, therefore, it will be difficult for microbial infection to take hold. Balance in Ayurveda is equivalent to health, which is equivalent to a strong and well-functioning immune system capable of defending against microbial infection. The Ayurvedic approach is to treat the whole person, including application of correct diet, lifestyle recommendations and herbal supplements. When a person develops an infection, the design of an Ayurvedic herbal formula reflects the holistic approach. Based on traditional use, herbs are selected and combined for their ability to inhibit microbial overgrowth in various parts of the body and support those organ systems responsible for detoxification and immune function.

The herbs listed below are traditionally used to manage cold, flu and infection. The chemical composition of each of the following plants tends to confirm their traditional use. Interestingly, each herb appears to possess properties that work on multiple biochemical pathways capable of influencing several organ systems simultaneously. The ancient practice of combining and concentrating several plants by decoction (extracting together in boiling water) that have a similar yet slightly different organ system focus, produces a finished product that treats the whole person along with the presenting complaint.

Indian lilac or neem (azadirachta indica)

  • Used traditionally in Ayurveda both topically and internally for microbial infection including those infections related to the skin such as acne, fungi, wound healing, antiseptic treatment, oral hygiene, parasite infection, fevers and general infections.
  • Neem oil is excellent for skin and hair usef skin diseases, ulcers and wounds.
  • Neem oil and two of its bitter principles, nimbidin and nimbidol, have exhibited antibacterial, antifungal and spermicidal activity.


Ginger rhizome (zingiber officinale)

  • Used traditionally for colds, other microbial infections, and the removal of mucous and toxins associated with microbial infections.
  • Most well known use as a digestive aid.


Guggulu gum (commiphora mukul)

  • Used traditionally in oral hygiene and skin diseases.
  • Acts as a bitter and carminative (prevents gas), stimulating the appetite and improving digestion.
  • The oleoresin portion of the plant causes an increase of leucocytes in the blood and stimulates phagocytosis.




Indian madder root (rubia cordifolia)

  • Used traditionally for uterine and urinary system conditions including infection.
  • Dried root acts as an emmenagogue, astringent and diuretic.


Amla fruit (emblica officinalis)

  • Used traditionally for fevers.
  • The fruit extract exhibits antibacterial and antiviral properties.



Boswellia gum resin (boswellia serrata)

  • Used traditionally for urinary disorders including infections.


Heart-leaved moonseed stem (tinospora cordifolia)

  • Used traditionally for antitoxin action and as a febrifuge (antipyretic/fever reducing)
  • Also used for urinary diseases, skin diseases and bronchitis.
  • One study showed that an ethanolic extract of tinospora cordifolia appeared to improve the phagocytic activity of the mononuclear phagocyte system in mice.


Long pepper fruit (piper longum)

  • Used traditionally for colds, other microbial infections and the removal of mucous and toxins associated with microbial infections.
  • The essential oil of the fruit shows antibacterial, antifungal and anthelmintic activity.
  • An ethanol extract of the piper longum fruit showed antiamoebic activity both in vitro and in vivo, curing 90% of rats with caecal amoebiasis.
  • An Ayurvedic herbal medicine prepared from piper longum and butea monosperma and prescribed for the treatment of chronic dysentery and worm infestations was tested for anti-giardial and immunostimulatory activity in mice infected with giardia lamblia trophozoites. The preparation produced up to 98% recovery from the infection and induced significant activation of macrophages as evidenced by increased macrophage migration index and phagocytic activity.

Diet And Prolotherapy

How diet can alleviate pain and support the benefits of prolotherapy.

By Renata Trister, DO

Moderate exercise is frequently recommended after prolotherapy procedures as it aids in proper healing. Diet can also have an impact on the efficacy of prolotherapy.  An anti-inflammatory diet helps treat chronic pain and recommend for maximizing the benefit of any prolotherapy treatment.

These are some quick ideas:

  • Balance your pH. Acidic diets cause inflammation and often pain.  To help regulate your body’s pH levels, doctors recommend drinking a lot of water and eating a diet rich in vegetables and protein. Eating too many carbohydrates and sugar can contribute to high levels of acidity in the body, so be sure to limit your intake of these foods to keep inflammation under control.
  • Eat omega-3 rich foods. Omega-3 fatty acids have been found to reduce inflammation and contribute to a number of other health benefits like the reduction of bad cholesterol. The best sources for omega-3s are typically fish, seeds and nuts, avocado and olive oil, but you can also take nutritional supplements like flaxseed or fish oil to easily add some omega-3s to your diet.
  • Avoid omega-6 rich foods. Foods that contain another kind of fatty acid, omega-6, however can increase inflammation and contribute to chronic joint pain.  Salad dressings, vegetable oils, cured meats, margarine and animal fat, reducing your consumption of omega-6s can help with chronic pain.
  • Eat more antioxidants. Antioxidants combat molecules in your body known as free radicals that come from smoke and pollutant inhalation and eating processed or genetically modified food. Free radicals contribute to the body’s degenerative processes, including aging and long-term disease. Antioxidants are found in berries, green leafy vegetables, seeds, nuts and fruits.


  • Eat less refined foods. In addition to having high levels of sugar, processed foods like soda and prepackaged baked goods can have a negative impact on immune function, which is critical in repairing damage to your body’s tissues. Avoid highly processed and refined foods to avoid their low nutritional value and ensure proper healing and immune function.

Estrogen, Testosterone and Cartilage Regeneration

Estrogen, Testosterone and Cartilage Regeneration

By Renata Trister, DO


Use of opiate pain medication has increased dramatically over the past 20 years. These medications seem to affect hormonal pathways leading to abnormal levels of different hormones, such as testosterone, cortisol and prolactin. Men with androgen deficiency (low testosterone) brought on by overuse of painkillers and other pain medications, showed improvements in pain, sexual desire, body composition, and aspects of quality of life. In other research it was noted that some patients with severe and chronic pain failed to obtain adequate pain relief with standard pain medications, including low to moderate dosages of opioids. Patients complain that a standard opioid dosage is ineffective. These patients may be severely impaired, nonfunctional, and bedridden or housebound. Doctors often have difficulty trusting these patients. To help characterize these patients and develop strategies for their treatment, a serum hormone profile consisting of adrenocorticotropin, cortisol, pregnenolone, progesterone, dehydroepiandrosterone, and testosterone was obtained on 61 chronic pain patients who failed standard treatments; 49 patients (80.3%) demonstrated hormone abnormality and 7 patients (11.5%) showed a severe pituitary-adrenal-gonadal deficiency as indicated by deficient serum levels of adrenocorticotropin and  more than 2 adrenal-gonadal hormones. The doctors concluded hormone serum abnormalities are biomarkers of severe, uncontrolled pain, and, in a patient who has failed standard treatment, they are an indicator that enhanced analgesia is required and that hormone replacement may be indicated.


Hormones regeneration damaged cartilage


With cartilage injuries anabolic hormones such as testosterone play a role in regeneration. Estrogen receptors are present in cartilage and that estrogen stimulates cartilage growth.  A recent study in Sweden, focused on the effects of testosterone on chondrocytes. The research concluded that testosterone promotes differentiation of chondrocytes and increases collagen production.   A low testosterone level in men and women can cause difficulty in healing.


Various hormone factors that can affect knee cartilage


Women are more likely to be injures during ovulation when estrogen levels are highest. Women on birth control or Premarin have increased risk of injuries and chronic pain. Higher levels of estrogen make women more likely to be injured due to connective tissue laxity. Testosterone has the great effect of helping ligaments tighten and tissues heal whereas estrogen unfortunately for woman helps fat accumulate and ligaments not heal. Estrogen inhibits fibroblastic profileration, collagen synthesis is inhibited the more estrogen a woman has in her blood. So for women who take birth control pills or Premarin or other estradiol (main estrogen) driven hormone replacement, you may wish to seek an alternative if you have chronic pain. In another study – how androgens (anabolic hormones) reversed cartilage damage. Women are two to three more times more common and more likely to have the disease become more disabling and aggressive than men. It suggests that a long-term androgen replacement may help prevent joint damage and disability. In conclusion, testosterone can help improve cartilage health and making sure your hormonal levels are optimal is important for healthy joints. Avoiding degenerative NSAIDs and steroid injections, and choosing regenerative treatments such as Prolotherapy and stem cell injection therapy, will allow patients to regenerate their cartilage and avoid joint replacement surgery.



Quick home remedies for managing mild intestinal infections.

Quick home remedies for managing mild intestinal infections.

By Renata Trister, DO


Mild bacterial intestinal infections do not always require antibiotics. Antibiotics also kill the healthy bacteria in the gut, which leaves you with a weakened immune system and an imbalance of intestinal flora.

Symptoms of bacterial intestinal infection are loss of appetite, cramps, abdominal pain, nausea, diarrhea, weight loss, vomiting. There are many ways in which we can support ourselves with things from the kitchen. Here are a few simple ideas.


  • No food outside your own home
  • Avoid foods like coffee, red pepper and fried foods they can be irritating.
  • Consume a lot of liquids to stay hydrated
  • Lemon tea: peel and cut three lemons, boil in a liter of water and add some honey to soften the flavor
  • Ginger tea: peel and cut one rhizome of ginger, boil in one liter of water, add honey if you want. Chewing ginger is also possible, but some caution: very hot! Ginger is extremely potent in curing nausea, but also relieves cramps.
  • Banana and soft mashed plantains may be eaten.
  • Garlic:  Garlic is a natural antibiotic, gives a boost to your immune system and nourishes the stomach tissues.

There are a few additional treatments one can choose:

  • Staying on a liquid diet for one day, drinking kefir/yogurt.
  • Peppermint oil: helps eradicate harmful bacteria in the small intestine. Peppermint oil is available in capsules in your health food store. Take one capsule after meals. Peppermint oil can cause some undesired side-effects. Peppermint tea is a valid alternative with less side effects.
  • Grapefruit seed extract
  • Oregano oil
  • Olive leaf, like garlic, is a natural alternative to antibiotics. Aloe juice is very soothing to the intestine.
  • Tumeric root extract


Often taking antibiotics is necessary, it is very important to follow an adapted diet on the side, which will help you restablish the natural bacteria. This diet will typically be low in carbohydrates and exclude sweet and starchy foods. You might also want to focus on fatty food to keep your caloric intake sufficient. Supplementing with probiotics and fish oil is also highly recommended.


Infections and antibiotic- resistance: Brief Introduction.

Infections and antibiotic- resistance: Brief Introduction

By Renata Trister, DO

A big concern of the Center for Disease Control (CDC) is the overuse of antibiotics and the development of antibiotic-resistant strains of bacteria. Epidemic outbreaks of bacterial infections may likely to occur if no antidotes exist to kill these resistant strains of “super bugs.”


There are concerns in the USA that the common use of antibiotics in hand soap and in our foods will make the antibiotics ineffective when they are really needed. Poultry and meat are often raised with hormones and antibiotics to increase size and improve health.


Anti-malarial drugs have resulted in more resistant forms of malaria, so drug companies are trying to develop stronger weapons against the disease. Intestinal parasitic infections, yeast infections and food borne pathogens have been on the rise. The strategy of fighting these microbes with anti-microbial drugs has only escalated to a war with drastic destruction looming.


Unfortunately, antibiotics indiscriminately kill not only the bad bacteria but also the good bacteria making up the intestinal environment. The need to find solutions with less dire consequences has led to increased research into using more natural remedies and taking the path of Traditional Chinese Medicine to find ways of enhancing the immune system versus blasting the microbe with a stronger bullet.


The gut is responsible for critical digestive, immunologic and barrier functions. Microorganisms can stimulate inflammatory responses in the gut leading to intestinal tissue destruction and mucosal barrier dysfunction. This can lead to the development of autoimmune responses and systemic infection.


Some most common natural antibiotics used in cooking include oregano, sage, lemon balm, garlic and ginger. These are effective against viruses, bacteria, fungi, worms, and parasites.  Probiotics also balance intestinal infection and inflammation through a different (opposite) mechanism.


However, high doses of active ingredients are required for an anti-microbial affect, so one should guard against unsafe use of herbs and seek manufacturer’s Certificate of Analysis to confirm extract specifications, standardization and potency by third party analysis.


Consulting practitioners and searching out pertinent information can help you find the balance needed for a healthy, functioning digestive tract. Choosing foods free from hormones, antibiotics or pesticides can also decrease the body’s exposure to chemicals. Also notify your physician when using these products.


There are no easy answers to getting healthy and staying healthy, but the first step to good health is making a decision to take that path and keeping yourself well informed in order to make wiser choices.


Herbal Antibiotics for Intestinal Issues, Renata Trister DO

Herbal Antibiotics for Intestinal Issues

The need for safe antimicrobials is on the rise to fight infectious diseases evident in all parts of the world. Increases in mass population movements, international travel, animal transport, improper food handling, misuse of antibiotic drugs and the subsequent drug-resistant microbes have led to an explosion of intestinal diseases, and thus a need for new, safe antimicrobials.

With the arsenal of antibiotics available to treat infection declining due to microbial resistance, the need for alternative treatments is greater than ever. A few natural and balancing antimicrobials are available. Not only do these natural antimicrobial agents improve intestinal health by treating infection, but they also offer secondary support to multiple organs and body systems. This secondary support further promotes recovery from infection.

Intestinal Flora and Systemic Disease

It is critical to understand the relationship between intestinal health and disease. The intestinal tract has digestive and immunologic functions that are crucial for good health. The intestinal tract acts as a barrier to prevent harmful microbes present in the gut environment from entering circulation.  Addressing intestinal infection and the negative impact on the health of intestinal tissue and barrier function is a start to addressing many medical conditions.

Pathogenic microbes invade the intestine inflammation and translocation occurs. The inflammatory response initiated by microorganisms is a contributing factor to the further destruction of intestinal tissue.When intestinal barrier function is compromised due to tissue damage, translocation can result. Translocation is a process wherein microbes exit the intestines and enter the blood, lymph, or visceral organs. With the involvement of both inflammation and translocation in increasing numbers of disease processes, it is critical to recognize and treat the intestinal tract.

Antimicrobial Compounds Found in Plants

Various herbs have been used clinically in humans for their antimicrobial activity, as well as for their beneficial effects on digestion and inflammation.Thanks to their unique properties, the following herbs may be used as carminatives (to expel gas) and digestive aids, as well as for eliminating harmful microbes, cleansing the intestinal tract, and defending against infection.

Aromatic Herbs (Phenols)

Red Thyme Oil (Thymus vulgaris) The primary ingredient in red thyme oil is thymol, whose actions focus on the intestinal tract. Red thyme oil has been shown to inhibit the growth of a wide variety of bacteria and fungi.

Oregano (Origanum vulgare) Like red thyme, a primary ingredient in oregano is thymol. In several studies, oregano has exhibited high levels of antimicrobial activity against a wide range of bacteria, parasites, and fungi.

Sage (Salvia officinalis) Sage prevents the growth of bacteria, fungi, and viruses, and is therefore used in the relief of digestive problems, flatulence, inflammation of the intestines, and diarrhea.

Lemon Balm (Melissa officinalis) Lemon balm supplies compounds called flavonoids, which support the actions of the immune system. Other substances found in lemon balm display potent antiviral activity; for example, by preventing further progression and multiplication of viruses, substances in lemon balm are known to neutralize viruses on contact.

Bitter Herbs (Alkaloids)

Berberine Berberine is found in medicinal plants such as coptis (Coptis chinesis) and barberry (Berberis aristata).It has been shown to have significant antimicrobial activity against bacteria, fungi, parasites, worms, and viruses.In addition, berberine inhibits the formation of microbial toxins.

Coptis Decoction A decoction of various herbs including coptis, phellodendron, rhubarb, ginger, and licorice help stabilize stomach and intestinal function. Such a decoction also improves the utilization of, and tolerance to berberine, thus complementing any formula containing high levels of berberine.

Other Antimicrobial Herbs

In addition to the herbal therapies mentioned above, the following foods have strong digestive, antimicrobial, and intestinal cleansing activity:

Garlic (Allium sativum)The use of garlic to fight pathogens has a long history. Its use against diarrhea caused by E. coli, as well as dysentery, cholera, and other infectious intestinal diseases. In addition, garlic has significant activity against fungi and parasites.

Ginger(Zingiber officinale) Ginger’s inhibitory effect on bacteria has been validated through in vitro experimentation.Recently, the number of Anisakis (a parasite found in many types of fish) infections in the United States has markedly increased due to the popularity of eating Japanese foods such as raw-fish dishes. Ginger has been shown to have a lethal effect on Anisakis larvae, eliminating both its viability and infectivity. Ginger also supports digestion and has anti-inflammatory activity.

Sour Plum (Prunus mume)Sour plum is used to treat diarrhea and dysentery, as well as expel hookworms and roundworms. This fruit also stimulates the purging of parasites from other digestive organs, including the gallbladder and bile ducts.

Wormwood (Artemisia annua) Wormwood has been used for the treatment of parasitic worms in China for over 1,500 years hence the name “wormwood.” The majority of current research on wormwood revolves around its use as an antiparasitic therapy.


As the number of intestinal infections continues to grow at a rapid rate, the importance of finding safe and effective therapies cannot be overlooked. While there exists a vast array of prescription medications to treat most forms of microbial infections, it is important to keep in mind the frequency and severity of adverse side effects that often accompany these types of treatments. Microbial resistance continues to deplete the effectiveness of existing medications, the need for alternative therapies is important.




by Renata Trister DO


Aromatherapy is actually a form of herbal medicine. However, instead of using the entire herb, it employs the fragrant “essential oil” that is released when a fresh herb is compressed or subjected to chemical extraction. Essential oils are also often used as fragrances in cosmetics and bath products.

When employed medicinally, essential oils are often evaporated into the air through the use of a humidifier. The famous Vicks VapoRub is a gel form of the essential oils of peppermint, eucalyptus, and camphor. Certain essential oils may also be applied directly to the skin or clothes so they will release their odor near the patient. Some essential oils are designed to be taken by mouth, but this is an uncommon usage.


What Is Aromatherapy Used For?

Inhaled aromatherapy has become a popular, gentle treatment to reduce mild anxiety. It has also been tried for a variety of other conditions, including respiratory problems, postsurgical nausea, menstrual pain, and tension headaches.

Topical treatment with essential oils has shown possible value for fungal infections and hair loss. Essential oils specifically designed for oral use have shown some promise for various digestive and respiratory problems.

What Is the Scientific Evidence for Aromatherapy?

There is a major difficulty in studying aromatherapy by inhalation: how to conduct a double-blind, placebo-controlled trial. For the results of a study to be truly reliable, both participants and researchers must be kept in the dark regarding participants who received real treatment and who received placebo. Although it may be possible to keep researchers in the dark regarding which group is which, participants will certainly be aware of whether they smell something or not! This is a problem because it has been shown that when researchers create expectations about the effects of certain aromas, those effects may occur simply because of those expectations.  Researchers have used various clever compromises in an effort to partially solve this problem. For example, some studies used a control group that received an aromatic substance believed to be ineffective, without informing the members of the control group that this alternate aromatic substance will not work. Unfortunately, it is just as hard to prove that an aromatic substance is ineffective as it is to prove that it is effective! If the placebo in a study is just as effective as the tested treatment, the study will falsely indicate that the tested treatment is ineffective. Furthermore, many odors already have associations attached them, based on cultural patterns. Lavender oil, for example, conjures up for many people memories of their grandmother. It simply is not possible to remove such expectations.

In other studies, researchers tricked participants in the control group and told them that they might be receiving an active but odorless treatment, when in fact they were simply given an inactive treatment without much in it. Still other studies managed to find ethical ways of keeping their study participants in the dark regarding whether they were enrolled in a study at all, and then introduced the odors surreptitiously. Partially effective compromises such as these are necessary.

Thus, everything written below about true aromatherapy—that is, inhalation of an aroma—must be taken with a grain of salt.

These problems do not arise to the same extent in studies of essential oils taken by mouth or applied directly to the skin.

Inhalation of Essential Oils

Alzheimer’s Disease and Other Forms of Dementia

Preliminary controlled trials suggest that various forms of aromatherapy might be helpful for calming people with Alzheimer’s disease and other forms of dementia.  For example, in one interestingly designed, but very small, study, a hospital ward was suffused with either lavender oil or water for two hours. An investigator who was unaware of the study’s design and who wore a device to block inhalation of odors entered the ward and evaluated the behavior of the 15 residents, all of whom had dementia. The results indicated that use of lavender oil aromatherapy modestly decreased agitated behavior. A less rigorous study also reported benefit with lavender. However, people with dementia tend to lose their sense of smell, making this approach seem somewhat limited in its usefulness. Essential oil of lemon balm has also shown promise for this purpose; in a double-blind study of 71 people with severe dementia, use of a lotion containing essential oil of lemon balm reduced agitation compared to placebo lotion. Here, absorption through the skin may have played a role.

Several relatively poorly designed studies hint that aromatherapy combined with massage may help to relieve anxiety in people without Alzheimer’s disease. Another study suggests that aromatherapy with geranium oil might modestly reduce anxiety levels (again in people without Alzheimer’s).

Researchers have also studied aromatherapy as a potential treatment for the cognitive (eg, memory) impairments caused by dementia.  In a small study, 28 elderly people with dementia (including 17 people with Alzheimer’s disease) were exposed to rosemary and lemon oil in the morning and lavender and orange in the evening for 28 days. When researchers compared the dementia assessment scores during the treatment period to the scores from the previous month (control period without aromatherapy), they found that all of patients experienced an improvement in their symptoms.

Cigarette Addiction

A controlled study suggests that inhalation of black pepper vapor may reduce the craving for cigarettes. 8 In this trial, a total of 48 smokers used cigarette substitute devices that delivered black pepper vapor, menthol, or no fragrance. The results showed that use of the black pepper-based dummy cigarette reduced symptoms of craving for the first morning cigarette.

Tension Headaches

Weak evidence hints that peppermint oil applied to the forehead might relieve tension headaches.

A topical ointment known as Tiger Balm has also shown promise for headaches. Tiger Balm contains camphor, menthol, cajaput, and clove oil. A double-blind study enrolling 57 people with acute tension headache compared the application of Tiger Balm to the forehead against placebo ointment as well as the drug acetaminophen (Tylenol). The placebo ointment contained mint essence to make it smell similar to Tiger Balm. Real Tiger Balm proved more effective than placebo and just as effective and more rapid-acting than acetaminophen.


In a trial of 66 women waiting to undergo abortions, 10 minutes of inhaling the essential oils of vetivert, bergamot, and geranium failed to reduce anxiety significantly more than placebo treatment.  In another study, rosemary oil failed to reduce tension during an anxiety-provoking task and might have actually increased anxiety.

However, other studies have shown more favorable effects. In one such trial, researchers assessed the anxiety level in 340 dental patients while they were waiting for their appointment. Those that inhaled the scent of lavender showed lower levels of anxiety compared to the control group. In another study, 150 patients were randomized to one of three treatment groups: control (standard care), standard care plus lavender, or sham (standard care plus another kind of oil). Those that were in the lavender group did experience a reduction in their level of anxiety.

Taking a different approach, researchers evaluated the effects of massage therapy done with essential oils on people suffering from anxiety and/or depression while undergoing treatment for cancer. The treatment did appear to provide some short-term benefits.

Other Conditions

Weak evidence suggests that inhaled peppermint oil might relieve postsurgical nausea.  Peppermint was associated with improved nausea symptoms in a small randomized trial of 35 women after nonemergency cesarean section compared to placebo aromatherapy and standard antiemetic drugs.

Inhaled peppermint oil may also be helpful for relieving mucus congestion of the lungs and sinuses; however, there is only weak supporting evidence for this use.

In one study, abdominal massage with lavender, rose, and clary sage reduced menstrual pain to a greater extent than an almond oil placebo. In another study, acupressure combined with lavender, rosemary, and peppermint aromatherapy was more effective than acupressure alone for treating the shoulder pain caused by a certain form of stroke.

Controlled studies have evaluated proprietary-inhaled aromatherapy preparations for treating the common cold and preventing flare-ups of chronic bronchitis, but the results were marginal at best. A study involving vapor rub found a more positive effect, though. One hundred and thirty-eight children (aged 2-11 years old) with upper respiratory infection were randomized to receive vapor rub (camphor, menthol, and eucalyptus oils), petroleum jelly, or no treatment.  The children who had vapor rub applied before bedtime experienced an improvement in their nighttime symptoms (eg, less coughing, less nasal congestion) compared to the other two groups.


More studies are on the way as the methods to research aromatherapy become more perfected.