Dr. Jacob Teitelbaum is the renowned author of “From Fatigued to Fantastic,” one of the premier texts on treating CFIDS and Fibromyalgia, as well as being the editor of a newsletter by the same name. He remains at the forefront of research and treatment of both CFIDS and FM. As a member of the Healthwatch Advisory Board, we are pleased to reprint a portion of the following article from Dr. Teitelbaum’s newsletter. If you would like more information about Dr. Teitelbaum’s book or newsletter, you may call 1-800-333-5287 or visit his website at www.endfatigue.com
Great in CFIDS/FMS!
Ginger can have wonderful health benefits, in CFIDS/FMS. Although native to Asia, Jamaica is the major producer, exporting over 2 million pounds a year. There are times that fresh Ginger (high in Gingerol) and dried Ginger (high in Shogaol) will have different effects. I will note the uses where this distinction is important. Although Ginger’s benefits are numerous, I’ll begin with those that mostly apply to CFIDS/ FMS. These include:
Relief of muscle and/or joint pain.
Many components of Ginger are, like aspirin and Motrin, potent inhibitors of inflammatory substances (e.g., Prostaglandins). Ginger is also thought to inhibit “Substance P,” a pain mediator that is known to be elevated in FMS. This is the same substance that Capsaicin (hot pepper) creams work through. For Substance P inhibition, dried Ginger seems to be most effective. In a study of 10 patients with muscle pains and 46 patients with arthritis (Rheumatoid and regular “wear and tear” osteoarthritis), 100% of muscle pain and 75% of arthritis patients noted relief. The recommended dose was 1000mg of powdered Ginger a day. Many patients took 3000-4000mg a day and noted quicker and better relief using the higher dose (Medical Hypothesis,39:342-8; 1992).
Nausea and vomiting is decreased by 500-1000mg of Ginger. Ginger also decreases bowel spasm while improving gastric motility (moving food out of the stomach to the bowels). These are often major problems in CFIDS/ FMS, resulting in bloating after eating. Ginger can also inhibit diarrhea. Fresh (e.g., roasted) but not dry Ginger inhibited stomach ulcers caused by aspirin and Motrin (in several animal studies).
Warming the body (increasing thermogenesis. The fresh Ginger works much better for this.
Migraine headaches are reported to be helped by Ginger.
Dysequilibrium (e.g., motion sickness).
Although likely not as effective for middle ear (vestibular Ñ where you feel like you are spinning in a circle) dizziness, it inhibits the nausea associated with dizziness. For motion sickness, it works best when 1000mg is taken 4 hours before travel.
Raising blood pressure (dry Ginger only). This can be helpful in CFIDS/FMS.
In addition to these benefits, Ginger can decrease the risk of heart disease by “platelet inhibition” (like aspirin and vitamin E do) and by lowering cholesterol. It is a strong antioxidant and can inhibit certain bowel infections (Salmonella and Vibrio) and, in 5% and 25% aqueous extracts, can be effective against vaginal Trichomonas infections.
Side effects of Ginger are minimal. Very high doses (e.g., 6000mg of dried ginger) on an empty stomach can cause stomach problems. It is rare that this high of a single dose is needed. The optimal dosing is not yet clear. Most research studies used 1000mg of dry powdered Ginger root (the form I’m using when I specify doses above). This is equivalent to about 10gm (1/3 oz. or about a 1/4 inch slice) of fresh Ginger root. Higher doses can be more effective initially for pain (e.g., 500-1000mg 3-4 times a day of dry powder) with the dose lowered to the lowest effective dose in 4-6 weeks.
Although not used in studies, ground Ginger (like ground garlic) in a liquid base for cooking and Ginger tea granules (supplying 5000mg of Ginger per cup of tea) are available. When fresh Ginger is used (for cooking or to make tea), do not peel it until just before use or some of the active (volatile) oils will evaporate.
Ginkgo Biloba: “I Forget Where I Left My Memory”
1. Ginkgo Biloba Extract (GBE) has been shown to have multiple benefits for memory and depression. These include:
A) Improving the decreased libido and erections and the delayed orgasm seen with antidepressant use (requires 60-80mg of Ginkgo, 3 times a day).
B) Decreasing the breast tenderness and mood shifts of PMS (Tamborini, A, et. al; Rev Fr Gynecol Obstet [France] 88:447-57; 1993).
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C) Helping to settle down dysequilibrium and vertigo (Haguenauer, J.P., et. al.; “Treatment Of Equilibrium Disturbances w/Ginkgo Biloba-A Multicenter, Placebo Controlled Study;” Presse Med 15:1569-72; 1986 and Smith, P.F., et al; “Can Vestibular Compensation be Enhanced by Drug Treatment: A Review of Recent Evidence;” J Vestib Res 4:169-179; 1994).
D) Memory. Improving memory in healthy young volunteers and in the elderly. This has been shown in many placebo-controlled studies (e.g., Grassel, E.; “Effect of Ginkgo Biloba Extract on Mental Performance,” Fortschr Med 110:73-6; 1992 and Hopfenmuller, W.; “Proof of the Therapeutic Effectiveness of a Ginkgo Biloba Extract – A Meta Analysis of 11 [Placebo Controlled] Trials in Aged Patients With Cerebral Insufficiency;” Arzneim-Forsch (Germany); 44:1005-1010; 1994 and Hindmarch, L.; “Activity of GBE on Short Term Memory,” E.W. Fungfeld (ed) Op Cit; pp.321-326; 1988).
Many CFIDS/FMS patients also find that Ginkgo helps their memory. In 12 healthy males, 120-240mg GBE improved EEG alpha brain wave activity in a way supporting improved cognitive function (vs. placebo).
In general, Ginkgo improves circulation in the brain and legs (in over 40 controlled studies). By improving circulation, Ginkgo may also decrease ringing in the ears (tinnitus) and headaches, as well as the finger artery spasm sometimes seen in SCIFDS (Raynaud’s Syndrome). Ginkgo may also lower cholesterol and help angina.
E) Treatment of asthma and bronchitis. In China, Ginkgo is made into a tea for this purpose.
F) Helping depression (at 80mg 3 times a day). The Ginkgo you buy should be a 50:1 extract standardized to have 24% Glycosides (it will say this in the label). For most purposes, 40mg three times a day is the standard dose. Treating depression, however, requires 80mg, three times a day. It takes six weeks to see the effect of treatment. No serious side effects have been reported and there are no known drug interactions (side effects with Ginkgo were often actually less than the side effects seen with placebo).
Kava: For Sleep and Anxiety
Kava, a member of the peppercorn family, has been one of the South Pacific’s most revered herbs and intoxicants. Used in most tribal Oceana cultures for hundreds of years, it was central to many social celebrations and often used as a remedy for a number of physical ailments, as well as a part of daily life. Uses include soothing the nerves, counteracting fatigue, inducing relaxation, aiding in weight loss and treating cystitus, urinary tract congestion and rheumatism. Hawaiian Kahunas (medicine men) used it extensively for ailments such as “general debility (especially in children), weary muscles (a great restorer of strength), chills and head colds, difficulty in passing urine and sharp, blinding headaches.”
Overall, Kava was “found to reduce fatigue, allay anxiety and to produce a generally pleasant, cheerful and sociable attitude…[sometimes] bordering on intoxication.”
Kava was traditionally prepared as a drink from the ground-up herb (after being strained). When used ceremonially, Kava was usually taken on an empty stomach in the evening. Since the root needed to be softened, it was usually pre-chewed by virgins or, in Fiji, by grating.
In the USA, it is usually taken in capsule form. A single dose containing 150-210mg of the “pyrones” is the usual dose to induce sleep (e.g., most capsules contain Kava with 70% Kava pyrones, so a 100mg capsule has 70mg of the pyroneÑtake 200-300mg at night for sleep). At this dose many people find that it relieves insomnia and induces a deep, restful sleep with clear, epic-length dreams. Upon waking, they feel rested.
When used for anxiety, the usual dose is a 100mg capsule three times a day. The effect begins in one week and increases over the next eight weeks. Interestingly, while several placebo controlled studies showed Kava to be effective for anxiety (as effective as Elavil and valium-type prescriptions), it did not cause any significant side effects-unlike the prescription sedating medications. Surprisingly, it actually improved mental functioning and clarity! Research also shows Kava to be an excellent muscle relaxant. It seems to work by a mechanism similar to Novocain (lidocaine)-which has been shown to be very beneficial in FMS.
Although most people do not get any side effects when using Kava alone for short periods, there are several concerns that result in my not using Kava as often as other natural remedies.
These concerns are:
Drug interactions. Kava may strongly potentiate (increase) the effect of other sedative medications. This resulted in a report of a person who was near comatose (short term) when he combined Kava with Xanax. Although a study combining alcohol (at blood level of .05%) and Kava in humans did not show problems, mice who took both together showed 10 times the increase in sleep time. If one does combine Kava with other sedating medications, do so only if it is essential, and begin slowly with very low doses. The German Commission E monograph on Kava suggests it not be used in pregnancy or non-situational depression (i.e., depression for no apparent reason).
Prolonged high doses may cause a dry scaly rash, which begins on the face and moves downward. Visual sensitivity to bright light may also occur. B vitamins may decrease this, as well as staying in the dose range discussed above. If the rash occurs, stop the Kava (or lower the dose).
Singh, Y.N., Blumenthal, M. “Kava- An Overview;” Herbalgram #39; pp 33-55.
Piscopo, G. Alternative Medicine Review; Vol. 2 #5; 1997; pp 355-364.