Herbal
support for Traumatic Brain Injury - powerpoint
version with
full references
General
recommendations and specific strategies
·Strategy: Help reduce short- and long-term impacts
of inflammation on brain tissue.
Plant flavonoids, such as anthocyanidins from blueberry (Vaccinium
macrocarpon), reduce inflammation and vasodilation helping with
swelling and edema. ¼ to ½ cup frozen blueberries
daily. They are also neuroprotective , acting through various intracellular
pathways to reduce neuronal damage, death, and dysfunction.
Glycosylated flavonoids, such as the ginkgo (G. biloba) flavo-glycosides,
directly reduce edema in brain tissue , improve circulation, and
can affect mood (see below). 240mg to 480mg of standardized (24%
flavo-glycosides) extract daily.
Curcumin, from Turmeric (Curcuma longa), has a long history of use
as a systemic anti-inflammatory, and has received recent attention
for treating central nervous system injury and inflammation , and
specifically for subarachnoid hemorrhage and traumatic brain injury
.
Specific essential fatty acids, such as the omega-3 EFA’s
from flax (Linum usitatissimum) seed known as DHA (docosahexanoic
acid) serve not only as building blocks for neuronal membranes,
but also participate in down-regulating proinflammatory signals
in brain tissue . 3-5 TBS ground seeds daily, or 2,000mg to 4,000mg
daily of oil.
While concentrated forms of these nutrients can be obtained from
herbs or herbal extracts, they are largely available through the
diet as well.
·Strategy: Provide essential neuron-specific metabolites
for the regrowth of brain tissue and optimal neuronal function.
Oats (Avena sativa) are used as a traditional medicine when prepared
from the unripe tops of the plant, either as an extract or as an
infusion. Oats are rich in calmodulin and phosphatidylinositol .
Traditionally used to improve nerve function following injury or
pathological degradation; this occurs perhaps through stimulation
of potassium channel expression and function. An infusion is taken
at the rate of 1 quart daily, steeped overnight with 5-6 tablespoons
of oat tops.
Botanicals with neuronal anti-inflammatory effects have also been
shown in animal models to increase rates of regeneration in damaged
retinal ganglion cells in the eye . We see the use of Ginkgo again,
combined with American Ginseng (Panax quinquefolium) and St. John’s
Wort (Hypericum perforatum).
·Strategy:
Manage peripheral symptoms (tremor, palsy, neuropathy).
Mullein (Verbascum thapsus) has been used as a piscicide , with
a somewhat analgesic effect in humans. It also has a history of
traditional use for symptoms of palsy. Valerian (Valeriana officinalis)
has therapeutic potential as an anticonvulsant, again echoed in
the historical record . Extract of both, at doses from 3ml to 5ml
three to five times daily, are taken in water. Huperzia (H. serrata)
has nootropic and neuroprotective effects taken as an extract that
provides a daily dose of 200µg to 400µg of the alkaloid
huperzine daily. Huperzia, also much researched as a treatment for
Alzheimer’s disease , seems to potentiate the effects of acetylcholine,
a central neurotransmitter involved in attention, alertness, focus
and memory.
External applications of the infused oil of St. Johnswort (Hypericum
perforatum) to areas with neuropathy if necessary. Also, capsaicin
from chili peppers (Piper frutescens) has received ample evidence
of effectiveness in treating neuropathy, probably through desensitization
of vanilloid pain receptors .
·Strategy:
Using caution in cases with hemorrhage, ensure optimal circulation
to the brain to reduce inflammation and promote regeneration.
Herbs such as hawthorn (Crategus spp.), rosemary (Rosmarinus officinalis),
linden (Tilia spp.), or ginger (Zingiber officinale) are chosen
and blended into tonic teas depending on the entire symptom profile
of the individual. Rosemary and ginger are strongly anti-inflammatory
and reduce neuronal injury secondary to inflammation.
·Strategy:
Manage associated neuropsychiatric symptoms. Episodes of
depression, mania, anxiety and insomnia are often associated with
the recovery from TBI. Specific botanicals can be selected to help
with these symptoms.
Depression is ameliorated by the circulatory stimulants listed above,
and by Rhodiola (R. rosea) which helps buffer the effects of stress,
protect the cardiovascular system, and re-awaken the central nervous
system primarily through its effects on chatecholamine neurotransmitters
. Doses of 3ml of the liquid extract once or twice a day are good
to start. St. Johnswort is also useful, at doses of 300mg to 900mg
daily, and especially in cases of a cold, depleted constitution.
See cautions below.
Mania can be buffered somewhat using the nervine tonics such as
scullcap (Scutellaria lateriflora) and lemon balm (Melissa officinalis),
although research on these botanical medicines is just beginning.
Anticonvulsants as described above can also be useful.
Anxious conditions benefit from ginkgo , kava-kava (Piper methysticum)
, and the nervine tonics described above. Kava-kava liquid extract
can be taken at doses ranging from 1ml to 3ml one to five times
a day.
Insomnia can benefit from valerian root extract, but the powder
or extract of ashwagandha (Withania somnifera), when coupled with
relaxation techniques, is quite restorative and effective for insomnia
. Ashwagandha also helps with central-nervous system cognitive symptoms
making it a good choice following TBI if the mentioned symptoms
are present.
·Other considerations: Adequate rest and
optimal nutrition are essential components to adequate recovery.
Additionally, techniques such as meditation and visualization can
be helpful as long as they are a part of an ongoing, focused program.
Simple rituals such as the brewing of a cup of tea can serve as
anchors during a tumultuous time; walks in gardens and woods soothe
the mind and refresh the body. Adequate exercise is also essential,
both physical and mental, and should be dovetailed to any rehabilitation
program.
·Cautions: A thorough history will reveal
any hemorrhagic progression the client may have experienced / be
experiencing. In these cases, caution is advised in the use of circulatory
enhancers, although the NO-inhibiting and vasoconstrictive effects
of compounds such as berry anthocyanidins should be encouraged.
A complete history of medications, both past and present, is also
essential to avoid the potential of herb/drug interactions, especially
between conventional anticonvulsant, antidepressant, and anti-inflammatory
medications and herbs such as St. Johnswort . Consult a qualified
herbalist.
