Low back pain is poorly treated according to a series of papers in the prestigious Lancet medical journal (1), which highlights that about nine million Britons suffer back pain but many receive drugs, surgery, and injections which can be useless or even harmful.

The evidence underpinning invasive treatments such as steroid injections and surgery is very weak and does not warrant using such techniques. Past studies have also shown that pain killers such as paracetamol or ibuprofen barely help relieve back pain.

A third of patients are then given stronger potentially dangerous opioids such as tramadol, codeine, and morphine which can end up making pain worse. Patients can also become hooked and suffer dangerous side-effects.

Herbal treatment could offer an alternative.  Evidence is provided by a Cochrane review (2) which shows three herbal supplements to be effective in treating episodes of back pain. The herbs tested were oral administration of Harpagophytum procumbens (Devil’s Claw) and Salix alba (White Willow Bark), and topical application of Capsicum frutescens (Cayenne). The review contained ten randomized controlled trials that included 1567 adults with non-specific acute or chronic low back pain. All three herbs reduced pain in comparison to placebos.

The approach taken by a medical herbalist in treating back pain depends on the particular presentation of each individual. The aim is to reduce the inflammation, which causes the pain, with anti-inflammatory, analgesic herbs such as those described in the Cochrane report as well as ginger, turmeric and boswelia. These herbs would be combined with others that reduce muscle spasm and relax muscles, restore the function of injured nerves, and promote structural healing of muscles and connective tissues.

Herbs are well tolerated and not only relieve low back pain, but also promote healing without any negative side effects. This allows healing and long term recovery rather than just suppressing the pain.

Herbal treatment for back pain could be combined with the social and psychological approaches advocated in the Lancet studies without the use of ineffective or harmful drugs and surgery.

1.  http://www.thelancet.com/series/low-back-pain (2018)
2. Gagnier, J.J., van Tulder, M.W., Berman, B.M., Bombardier, C. (2011) Herbal medicine low-back pain. Cochrane Summaries. http://summaries.cochrane.org/CD004504/herbal-medicine-for-low-back-pain

What is the menopause?

Menopause is a natural process which is inevitable but many women do not know what to expect.

The first stage of the menopause is called the perimenopause and it can begin anywhere between two and ten years before the menopause. It is a time when hormone levels fluctuate widely and oestrogen production by the ovary begins to gradually decline.

The menopause is reached when you have not had a period for 12 months.

What are the symptoms of the menopause?

The most common first symptom of the perimenopause is a change in how the menstrual cycle works. This can results in more or fewer periods, lighter or heavier bleeding and often a change in symptoms and severity of pre-menstrual syndrome (PMS). PMS symptoms of mood swings, swollen breasts and stomach cramps may worsen.

Other symptoms of the perimenopause and menopause can include hot flushes, difficulty in sleeping, vaginal dryness, mood changes, joint pain and headaches. Every woman’s experience of the menopause is different.

How to approach the menopause

Making changes to improve health can greatly reduce the severity of these symptoms. The key is improving diet and taking regular exercise.  Diet should consist of plenty of vegetables and fruit-providing fibre, vitamins, minerals and other phytonutrients. 

Protein sources should ideally consist of chicken, fish and legumes such as beans and pulses. Increasing the intake of legumes, including soya, together with flaxseed provides a source of phytoestrogen and is an effective way of modifying the effects of fluctuating oestrogen levels.

It is important to prevent weight gain by cutting down on processed foods that are high in refined sugar. Exercise helps control weight, reduce hot flushes and raise mood.  It is possible to include exercise such as walking that can more easily fit into your daily schedule but should also include resistance exercises or Pilates to help maintain bone density and prevent osteoporosis - brittle bones.

How herbs can support the menopause

Herbs can provide an effective way of managing the changes experienced during the menopause. Beneficial herbs include Chaste Tree to help balance hormone levels and regulate menstruation, and Ladies Mantle and Shepherds Purse to help reduce heavy menstrual bleeding. Herbs that help control mood changes include St John’s Wort and Vervain. Sage can be effective in reducing hot flushes. 

It is important to minimise the effects of stress during the menopause and this can be supported with herbs that balance adrenal function such as Ashwagandha, Siberian ginseng, and Rhodiola.

Why visit a Medical Herbalist?

A medical herbalist can help you manage the transition through the perimenopause and menopause. Each woman has a different experience and a medical herbalist will provide dietary advice and select herbs tailored to the changes and symptoms that you are experiencing.

Contact me at the Clinic to arrange an appointment.


“I approached Gina because I was looking for a natural way to manage some symptoms of being (what I suspected was) peri-menopausal. Symptoms included night-sweats, aching joints, intermittent IBS, bad sleep pattern and irregular periods. 
 
Gina helped me by looking at my symptoms, and lifestyle (food, exercise, previous medical history etc) and coming up with a holistic approach that fitted in with my busy work/life schedule. “
Mrs Jacky Cumberland
 

What is food intolerance?

Food intolerance is the inability to properly digest certain foods. The symptoms of food intolerance include bloating and flatulence, stomach pain, headaches, skin rashes, and fatigue. It is a common cause of IBS.

How a Medical Herbalist can Help

A Medical Herbalist can help both identify the cause and help ease the symptoms of food intolerance.

 What approach will a Medical Herbalist take to identify the cause? 

The approach taken by a Medical Herbalist is to identify foods that may be causing the reaction by recording the symptoms, taking a medical history and using a food diary to identify a specific exclusion and reintroduction diet. The common causes of food intolerance include wheat based foods, gluten, dairy, eggs, soya, nuts, and some fruits. Advice is given on how to systematically carry out the diet to identify the one or more foods causing the symptoms while maintaining a balanced diet.

Also offered is another faster but more costly way of finding food intolerances which is to measure food-specific IgG antibody in a finger prick blood test. One company is able to test 150 different foods in one blood sample. This can be helpful in identifying foods but does not always given an accurate answer as food intolerances can have a number of causes which may not be evident from only measurement of IgG.

How will a Medical Herbalist treat food intolerance?

A Medical Herbalist will use herbal medicines to reduce factors that may have contributed to the food intolerance. These include herbs to improve digestion to ensure food is fully digested, to repair a leaky gut wall that may have allowed partially digested food into surrounding tissue, and to improve liver function.

To help ease the symptoms of food intolerance herbs will be given to reduce inflammation, bloating and contraction of the wall of the digestive tract wall, and to restore normal gut flora. The herbs selected will depend on the symptoms experienced by each individual.

Why visit a Medical Herbalist?

A Medical Herbalist will help you identify the cause of your food intolerance, recommend improvements to your diet and provide herbal treatment to ease digestive comfort.

Contact me to arrange a consultation at the Clinic to discuss your diet and symptoms.    

'I thoroughly recommend Gina, she is an extremely well qualified and experienced Medical Herbalist'
Mrs Vera Nugent
 

Fibromyalgia is a nasty illness that makes life miserable and can lay people low for long periods. It will certainly become better known given the sad news that Lady Gaga is suffering from it and has cancelled her huge European tour. It's too late her many disappointed fans but an accidental by-product is that more people will now know about the illness and how to treat it.

First, what is fibromyalgia? There is no definitive test as yet but its symptoms include generalised aching, muscle pains, trigger points around tendon insertions, muscle stiffness, fatigue, and poor sleep. It may affect as many as one in twenty people.

The cause of fibromyalgia is unclear but it can be initiated by poor sleep, emotional stress, infection, or a traumatic event. It is often associated with reduced 'delta sleep' - the deep stage of sleep in the first part of the night that analysts think has a vital restorative function. Other symptoms include a reduced threshold to pain perception and tolerance, adrenal depletion, and abnormal growth hormone levels.

The orthodox treatment for fibromyalgia includes pain relief with NSAIDs, antidepressants, and sleep medications. But there are possible side effects.

Herbal treatment can offer more. It is a gentle treatment with few side effects that acts on the body as a whole to normalise function. It can be varied so that it treats the possible cause and reduces the symptoms experienced by each individual.
The actions of herbs that may be selected include nerve tonics to help manage pain. Adrenal tonics and adaptogens to normalise cortisol release from the adrenal gland, immune modulating herbs, anti-inflammatory and analgesic herbs, herbs that reduce anxiety and reduce sympathetic nerve over activity to help promote sleep and herbs that increase blood supply to tissue.

Treating fibromyalgia with a combination of herbal medicines plus improving diet and exercise is an effective way to treat this debilitating condition. I wish Lady Gaga a quick recovery and that she can get back on the road soon.

We all suffer from stress at times in our lives. Students are now experiencing the stress of exams. Some stress can be helpful and healthy in preparing the body for an optimal response to a demanding event but continuous stress can be damaging.

According to a recent BBC programme stress accounts for half of all sick days and is considered the health epidemic of the 21st century. We can be exposed to a variety of pressures throughout the day which initiate stress responses by the body. Some stress can be effectively harnessed to perform well in exams and sporting events. It is the chronic daily stress that can have a detrimental effect on the body causing long term health problems through increased blood glucose, blood pressure, anxiety and depression as well as a weakened immune system.

Ours bodies are well adapted to responding to acute stressful events which ensure the ‘flight or fight’ response where the release of adrenaline and cortisol from the adrenal glands prepares the body for coping with a stressful event.  If the stress is ongoing and the body is unable to return to a restful state, adrenal cortisol secretion is prolonged and we can become exhausted and no longer able to focus and perform effectively.

The BBC programme described three ways to improve our response to stress: improved diet, regular exercise, and mindfulness. Herbal medicines should be added to this list.

Herbal medicines can provide an effective way of normalising the adrenal response and help us to responding effectively to stress. A key group of herbs are the adaptogens, which act on the brain-adrenal axis to balance the release of adrenal hormones.  Herbs shown to have this action include Siberian ginseng , Ashwagandha ,Rhodiola, Astragalus and Schisandra. Others herbs which help cope effectively with stress are nervines or nerve tonics such as Oat seed, Skullcap, and St John’s Wort which are calming and relaxing, restore emotional balance, and nourish the nerves and nervous system. Combining adaptogens and nervines herbs restores the function of the nervous and adrenal systems and allows the body to normalise its response to stress.

The choice of herbs will depend on each person’s stress response but finding the right herbal mix and combining it with improvements in diet and exercise could lead to improved quality of life and increased ability to cope with stress.

There is growing evidence that certain drugs prescribed for heartburn are associated with a number of adverse effects and are overprescribed.

Proton pump inhibitors (PPIs) such as Omeprazole and Lansoprazole reduce acid production in the stomach and are amongst the most commonly prescribed drugs. They are used to treat various conditions where there is abdominal pain and heartburn - most often acid reflux. 60% of adults will experience some type of acid reflux in a 12 month period.

The NICE guidelines state that PPIs should be prescribed for less than 8 weeks but many people, particularly the elderly, take them for considerably longer and sometimes up to decades. Concern is growing about the long term effects of continually taking these drugs. Evidence is mounting that they can increase the risks of heart disease, kidney disease, vulnerability to stomach infections, and dementia as well as weakening bones and causing mineral and vitamin deficiency such as magnesium and vitamin B12.

There needs to be a review of the risk/benefit balance of taking these drugs long term and changes made to how they are prescribed. Unfortunately, there can be a rebound effect in coming off drugs used to combat hyperacidity but if well managed this is usually short lived.

Herbal medicines can be used to help withdrawal from taking PPIs and offer an effective treatment for acid reflux. There is a wide range of herbal medicines which can be used for treatment. The herbs selected will depend on the causes and the symptoms experienced by each individual. The herbal actions include improving protection of the oesophageal lining, reducing acid production, reducing inflammation, promoting tissue healing, increasing the tone and effectiveness of the lower oesophageal sphincter, encouraging the stomach to empty its content into the duodenum, antibacterial, reducing gas production, optimising digestive enzyme production, and reducing nervous tension and the effects of stress.

You need to consider the long term benefits of taking PPIs.  If you have acid reflux, take charge of your condition, make changes in diet and life style, and take herbal medicines as a safe, effective alternative.

Bladder infections, also called Cystitis, result from bacteria such as Escherichia coli and cause great discomfort. They mainly affect women resulting in a frequent need to urinate, pain on urination and, if bladder inflammation progresses, blood in the urine. Cramps may also occur after urination.

Antibiotics are given to treat the infection but those suffering from recurring urinary infections are repeatedly treated with a course of antibiotics only for the infection to return. There is also a condition known as interstitial cystitis where there are symptoms resulting from chronic inflammation of the bladder but no infection.

Herbal medicines have much to offer and can be particularly effective in treating and preventing urinary infections.  There is a range of herbs which can fight the infection, reduce pain and inflammation, repair the bladder wall, and enhance the ability of the body’s own immune system to fight infection.

I have had success in treating urinary infections and inflammation with a combination of herbs tailored for each individual. Using herbal medicines prescribed by a Medical Herbalist offers both a much more effective long term treatment for inflammatory conditions of the bladder and also prevents the overuse and potential resistance to antibiotics.

About four-fifths of 40-60 year olds are either overweight, take insufficient exercise or  drink too much alcohol.  The bad news for health policy is that more such people are being identified as being pre-diabetic. The good news is that four-fifths of cases of type 2 diabetes could be delayed or prevented through making lifestyle and dietary changes.

Pre-diabetes is classified as increase in blood glucose levels to higher than normal but not high enough to be diagnosed as type 2 diabetes. Measurements of fasting plasma glucose (6.0 – 6.9 mmol/l)  and glycated haemoglobin (HbA1c (43 – 47 mmol/mol) are used to identify poor control of blood glucose levels.

Seven million people are estimated to have pre-diabetes and thus at higher risk of developing type 2 diabetes. Each year 5% to 10% of people with pre-diabetes develop type 2 diabetes, a chronic disease with life-threatening complications.

The good news is that if you are pre-diabetic and you act now, you could stop type 2 diabetes in its tracks. The risk of developing diabetes is minimised by catching the condition early as pre-diabetic signs can precede full-blown type 2 diabetes by many years.

You can, therefore, make changes that significantly improve glucose control.  This requires better diet and lifestyle. And that can be effectively combined with treatment using herbal medicine. It is estimated that about 80% of cases of type 2 diabetes could be delayed or prevented through making these changes.

The early control of blood glucose stops the need for drugs, and the dangers of long-term complications such as heart and kidney disease, blindness and nerve damage, leading to amputations.

The key to treatment is to increase insulin production and then the response to insulin.  Weight loss is a very crucial part of lifestyle changes needed to achieve this. Losing >5% can reduce low level inflammation and insulin demand, and increase insulin response.

Diet changes should include less saturated fat intake, more fibre, no refined carbohydrates, plenty of vegetables and low fruit, as well as moderate protein intake including more nuts, which also curb the risk of diabetes development.  Exercise of at least 30 minutes for five times a week starting with gentle walking is very important as are good sleep patterns which aid weight loss.

Treatment with herbal medicines enhances the benefits of these vital life style changes. A group of herbs which are particularly beneficial are spices such as ginger, garlic, cinnamon, turmeric and capsicum. These reduce inflammation and help balance blood glucose. Other effective herbs in controlling blood glucose include Gymnema, Fennel,  Liquorice, Goat ’s rue, Ginseng and Baical skullcap.

A Medical Herbalist will select the best of these glucose-controlling herbs for each individual and combine them with others to improve liver function, lower cholesterol, improve vascular function and reduce inflammation. They will advise which nutritional supplements are necessary for balancing blood glucose. These include chromium, magnesium, omega 3 fatty acids, vitamin B, vitamin D and zinc which are very important for normalising glucose levels.

Combining crucial life style changes with herbal medicine treatment provides a real opportunity to reverse poor control of blood glucose and prevent the development of type 2 diabetes. This will avert long term health problems and improve the chances of continued good health and well being.
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The natural process of menopause is inevitable but the good news is that its pains can be managed with natural herbal medicine and the other good news is that women have time to prepare for the menopause.

The first stage of the menopause is called the perimenopause and it can begin anywhere between two to ten years before the menopause. It is a time when hormone levels fluctuate widely and oestrogen production begins to gradually decline.

The most common symptom of the perimenopause is a change in how the menstrual cycle works.  This can result in more or fewer periods, lighter or heavier bleeding, and often a change in symptoms and severity of pre-menstrual syndrome (PMS).  

PMS symptoms of mood swings, swollen breasts, and stomach cramps may worsen. Other symptoms can include hot flushes, difficulty in sleeping, vaginal dryness, and headaches. Every woman’s experience of the perimenopause is different.

Making changes to improve health can greatly reduce the severity of these symptoms. The key is improving diet and taking regular exercise.  Diet should consist of plenty of vegetables and fruit-providing fibre, vitamins, minerals and other phytonutrients. 

Protein sources should ideally consist of chicken, fish and legumes such as beans and pulses. Increasing the intake of legumes, including soya, together with flaxseed provides a source of phytoestrogen and is effective way of modifying the effects of fluctuating oestrogen levels.

It is important to prevent weight gain by cutting down on processed foods that are high in refined sugar. Exercise helps control weight, reduce hot flushes and raise mood.  It is possible to include exercise such as walking that can more easily fit into your daily schedule but should also include resistance exercises or Pilates to help maintain bone density and prevent osteoporosis - brittle bones.

Treatment with herbal medicine can also provide an effective way of managing the changes experienced during the perimenopause. Beneficial herbs include Chaste Tree to help balance hormone levels and regulate menstruation, and Ladies Mantle and Shepherds Purse to reduce heavy menstrual bleeding. Herbs which act on the nervous system to control mood changes include St John’s Wort and Vervain. Sage is effective in reducing hot flushes. 

It is important to minimise the effects of stress during the perimenopause and this can be supported with herbs that balance adrenal function such as Ashwagandha, Siberian ginseng, Rhodiola and Schizandra.

Herbal medicines prescribed by a Medical Herbalist provide treatment which can be tailored to the changes and symptoms experienced by each woman. When combined with diet and exercise this provides an effective way of minimising changes during the perimenopause allowing a smooth transition through both the perimenopause and the menopause.

Mental Health Awareness week recently highlighted the often hidden reality that one in four of us experience some sort of mental health problem but resources for NHS treatment are limited.

We need to do much more to boost prevention and early intervention. Mental health care has now been declared a high priority and solutions are being sought. As well as improving NHS services, we should examine ways of preventing demand for NHS treatment in the first place.

There is increasing evidence, for instance, of the benefits of gardening and growing food to improve mental health for those suffering acute or persistent problems.

Other forms of treatment need to be considered. Using herbal medicine prescribed by Medical Herbalists, together with diet and lifestyle advice and the therapeutic benefits of a consultation, can be very effective in treating anxiety and mild to moderate depression, improving general health and vitality, and helping to limit the side effects of drug treatment. Such early intervention can stop such issues seriously deteriorating.

Many herbal medicines can be beneficial. St John’s Wort is a well-proven treatment for mild to moderate depression. Other important nerve tonic herbs include Skullcap, Vervain and  Schisandra.  Anxiolytic herbs such as Passionflower and Valerian are used to treat anxiety together with herbs that restore adrenal function such as Liquorice, Rhodiola, Withania and Siberian ginseng.

Using these herbal medicines with their gentle action and few side effects in combination with diet advice, and a listening ear could provide a turning point to improving mental health and a way of avoiding the need for NHS treatment.