Plant Medicine for Menopause

CHICAGO—Nutritional supplements, along with diet, exercise and stress management, can help women feel their best as they enter perimenopause and menopause, according to Tori Hudson, N.D., clinical professor, National college of Naturopathic Medicine, and director, A Woman’s Time Clinic, who spoke at the eighth annual Natural Health Research Institute (NHRI) symposium.

As a practitioner, Dr. Hudson said her primary job with perimenopasue and menopause patients is to make them feel better, reducing symptoms such as hot flashes, while not increasing the risk of other diseases. This is where plant medicine can shine.

Dr. Hudson said black cohosh (Cimicifuga racemosa) is the most researched plant for menopause symptoms with more than 100 published scientific papers and presentations. Black Cohosh does not have estogenic action and does not contain phytoestrogens, which is why it is thought to be safe in breast cancer patients.

Most of the black cohosh studies show 50-percent reduction in hot flash symptoms or more, and some show mood support, she said. She mentioned a 2004 in vitro study that found isopropanolic black cohosh extract was safe for women with a history of breast cancer (Menopause. 2004 May-Jun;11(3):281-9.) And a 2007 study showed is was associated with  a 61-percent reduction in breast cancer risk (Int. J. Cancer 2007; 120:1523-1528).


Ginseng is another herb Dr. Hudson uses in menopausal patients. She noted a 2012 study found red ginseng reduced menopause symptoms significantly, including hot flashes (Menopause 2012;19(4):461-466). This study also found it decreased total cholesterol and low-density lipoprotein (LDL) cholesterol. Dr. Hudson cautioned that ginseng could cause insomnia, so she recommends her patients take it in the morning.

In a 2006 study, Dr. Hudson said 100 mcg of hops significantly decreased menopause symptoms after six weeks, but not after 12 (Maturitas. 2006 May 20;54(2):164-75). She said she recommends hops for help with menopause, but doesn’t rely on it alone; instead, she combines it with other menopause-helping ingredients.


Kava can also help address menopause symptoms, as a 2000 study found it reduced anxiety in menopause patients, especially in women who were also taking hormone replacement therapy (Minerva Ginecol. 2000 Jun;52(6):263-7). Another study found  kava reduced anxiety within one month in perimenopausal women  (Maturitas. 2003 Feb 25;44(2):103-9).

While Dr. Hudson noted some reports have shown kava can be associated with liver damage, she said doses of up to 210 mg kavalactones per day should be safe.





Kudzu (Pueraria mirifica) may be growing all over the southern United States, but it also helps women as they enter menopause, Dr. Hudson explained. A 2007 study found 20, 30 or 50 mg/d of kudzu decreased vaginal dryness in women with menopause after 12 weeks (Menopause. 2007 Sep-Oct;14(5):919-24). And in 2011, a study found 25 and 50 mg/d increased sexual health in menopausal women (Arch Gynecol Obstet. 2011 Aug;284(2):411-9). However, Dr. Hudson noted kudzu is rich in phytoestrogens, so she avoids using it in breast cancer patients





Maca (Lepidiym meyneii) , a south American herb, at 3.5 g/d reduced anxiety, depression and sexual dysfunction in a randomized clinical trial of postmenopausal women (Menopause. 2008 Nov-Dec;15(6):1157-62). And a 2012 review found maca had a positive effect on sexual dysfunction in menopausal women (BMC Complement Altern Med. 2010 Aug 6;10:44).








Red clover, an isoflavone extract, works mildly  Dr. Huson said. She said doesn’t use it much because it’s hit and miss. However, she noted a 2010 study found red clover extract with  80 mg of isoflavones, reduced anxiety and depression in postmenopausal women (Maturitas. 2010 Mar;65(3):258-61).






A double blind Taiwanese study with peri-menopausal women found French maritime pine bark (as Pycnogenol from Horphag Research) decreased blood pressure, increased high-density lipoprotein (HDL) cholesterol and decreased the perimenopause symptoms of depression, anxiety, sexual dysfunction and insomnia (Acta Obstet Gynecol Scand. 2007;86(8):978-85).




Dr. Hudson covered Sibiric rhubarb (Rheum rhaponticum), an herb that’s currently only sold to professionals. A 2006 study found 250 mg of the botanical reduced hot flashes and anxiety, and increased well-being (Menopause. 2006 Sep-Oct;13(5):744.-59)






Lastly, Dr. Hudson noted St. John’s Wort at 900 mg/d for 12 weeks in menopausal women improved psychological and psychosomatic symptoms as well as feelings of well-being (Adv Ther. 1999 Jul-Aug;16(4):177-86).

Immune Cells Could Protect Against Obesity

New research has found that a type of anti-tumor immune cell  protects against obesity and the metabolic syndrome that leads to diabetes.

Results showing that immune cells known to be protective against malignancy  called invariant natural killer T-cells (iNKT),  that are lost when humans become obese, but can be restored through weight loss, have been published online this week in the journal Immunity.

Marie Curie Fellow, Lydia Lynch at Trinity College Dublin, Ireland made the discovery and as first author in collaboration with colleagues at Harvard-affiliated Beth Israel Deaconess Medical Centre, and St Vincent’s University Hospital have shown that therapies that activate iNKT cells could help manage obesity, diabetes, and metabolic disease.

iNKT cells had been thought to be rare in humans until work by  Dr  Lydia Lynch at Trinity College Dublin, Consultant Endocrinologist at St Vincent’s University Hospital  Professor  Donal O’Shea,  and Trinity’s Professor of  Comparative Immunology, Cliona O’Farrelly, found they were plentiful in human omental fat.

“We then found a large population of iNKT cells in fat tissue from mice,” said Dr Lynch whose Marie Curie Fellowship gave her the opportunity to work with Mark Exley and Steve Balk both assistant professors of medicine at Harvard Medical School  (HMS) and  leaders in the field of natural killer T-cell (NKT) investigations. “Now we have identified a role for these cells in the regulation of body weight and the metabolic state, likely by regulating inflammation in adipose tissue.”

The team also discovered that a lipid called alpha-galactosylceramide (aGC) can lead to a dramatic improvement in metabolism, weight loss, and fatty liver disease, and can reverse diabetes by bolstering cells that have been depleted.

Dr Lynch first began this line of investigation in 2007 where her work with Professor Donal O’Shea  in the Obesity Clinic at St Vincent’s University Hospital  in Dublin focused on the immune systems of obese patients. All human data was from Irish patients and carried forward to Boston. “We knew that not only did obese patients have more heart attacks and a greater incidence of type 2 diabetes than lean individuals, but they also developed more infections than non-obese individuals,” she said.

Blood samples taken from these patients revealed that both NKT cells and iNKT cells were decreased, and subsequent studies of fat tissue from a group of obese patients who had lost weight following bariatric surgery showed that iNKT cells had increased to normal levels.

In this new research, conducted with colleagues at BIDMC, St. Vincent’s University Hospital, and Trinity College Dublin, the authors conducted a series of animal experiments to test their hypothesis that iNKT cells play a role in fat tissue regulation and protect against the development of inflammation and the metabolic syndrome.

Previous research by Professors Mark Exley and Cliona O’Farrelly had described  large numbers of  iNKT cells in human and mouse  liver tissue; the group therefore needed to ascertain that, like humans, mice also harboured these cells in fat .

“We found loads of them,” Dr Lynch said.

The research team then put the mice on a high-fat diet and studied the outcome.

“Similar to the human subjects we had previously studied, the animals lost their iNKT cells when they became obese,” Lynch said. “Once we took them off this diet and put them back on a normal standard-fat diet, they lost the weight — and their iNKT cells increased.”

In the next experiment, the authors set out to better understand the exact role of the iNKT cells by examining two strains of mice, both of which are deficient in iNKT cells, and a group of control mice, all on a high-fat diet.

Although all the animals grew obese, the iNKT-deficient mice grew 30 percent fatter than the control animals and developed the mouse equivalent of type 2 diabetes over just six weeks. The mice also had greatly increased triglyceride levels, larger fat cells, and fatty liver disease.

Next, the authors removed iNKT cells from a normal mouse and injected them into obese NKT-deficient mice.

“We actually reversed the diabetes, and even though the mice continued to eat a high-fat diet, they lost one to two grams of weight [normal mouse weight being 20 to 25 grams] and exhibited a host of features that suggested reduced inflammation, including improved insulin sensitivity, lower triglycerides and leptin, and shrunken adipocytes,” Dr  Lynch said.

Finally, in order to demonstrate if the remaining diminished pool of iNKT cells in obesity could be activated to improve metabolism, the scientists tested aGC, a lipid known to activate iNKT cells. They found that administering a single dose of aGC caused a dramatic improvement in metabolism and fatty liver disease, loss of much of the weight gained, and reversal of diabetes in the obese animals.

“aGC has been tested   in clinical trials for the treatment of certain cancers, including melanoma, and proven safe and produced few side effects in humans,” said Exley. “The effect of NKT stimulation, whether by aGC or other means, on weight loss, obesity, and metabolic disorder has not been investigated until now and may provide a new avenue for the treatment of obesity and metabolic syndrome, which have now reached epidemic proportions worldwide.”

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