Functional Phytotherapy for Clinical Success · textbooks on herbal medicine, including his latest,...

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Functional Phytotherapy for Clinical SuccessKerry BoneAdjunct Professor New York Chiropractic College

Disclaimer

Integria Healthcare and Standard Process®sponsor these webinars to provide health care information to practitioners and to provide them the opportunity to hear about the views, recommendations and experiences of other practitioners. Health related information provided here is not a substitute of medical advice.Integria, Standard Process and the speaker, Kerry Bone, have not evaluated the legal status of any products (except for Standard Process and MediHerb products), services or recommendations with respect to state or federal laws, including scope of practice. Integria, Standard Process and Kerry Bone do not and cannot accept responsibility for errors or omissions or for any consequences from applications of the information provided and makes no warranty, expressed or implied, with respect to the information provided.

Recommendations for Standard Process and MediHerb product dosages are those of the speaker and sometimes different than the doses that appear on the product labels. Please refer to the product labels or to the product descriptions found in the product catalogs or on the website for Standard Process and MediHerb dosage recommendations.

*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.

Professor Kerry BoneKerry Bone is the co-founder and innovation driver at MediHerb, where he serves as Director of Research and Development. In 2016 MediHerb was awarded the American Botanical Council’s (ABC’s) Varro E. Tyler Award for excellence in Phytomedicinal Research. As part of his educational role, Kerry is Principal of the Australian College of Phytotherapy and also Adjunct Professor at New York Chiropractic College, providing input into their postgraduate applied nutrition program. Kerry is co-author of more than 30 scientific papers on herbal research. He has also written and co-written six popular textbooks on herbal medicine, including his latest, the second edition of Principles and Practice of Phytotherapy which was awarded the 2013 James A. Duke Excellence in Botanical Literature Award by the ABC. Kerry maintains a busy herbal and naturopathic practice in Toowoomba, Queensland, where he has been in continuous service for more than 30 years. In 2015, Kerry’s lifelong contribution to the field of herbal medicine was recognized with his receiving the prestigious Lady Cilento award from the complementary medicine industry in Australia.

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Our Topics

• Success with symptom-based prescribing

• Functional phytotherapy roots

• What is functional medicine?

• Defining functional phytotherapy: key attributes

• Twelve core strategies of functional phytotherapy

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Success with symptom-based prescribing

Mauro Raffaelli/ CC-BY-SA-3.0 / https://commons.wikimedia.org/wiki/File:584-fiori_di_incenso.JPG

15 Reliable Herbs that Deliver Results!

• Boswellia

• Licorice

• Tribulus

• Andrographis

• Echinacea Root

• Kava

• Rhodiola

• Ashwagandha6

• Horsechestnut

• St John’s Wort

• Eyebright

• Gymnema

• Gotu Kola

• Ginkgo

• Korean Ginseng

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Boswellia joint health post-exercise musculoskeletal

inflammation in general gastrointestinal health best in combination

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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013


Licorice HPA axis support;

adrenal restoration reduces sweet cravings addresses indigestion

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Image: Raffi Kojian/http://Gardenology.org/ CC-BY-SA-3.0 / https://commons.wikimedia.org/wiki/File:Gardenology.org-IMG_2804_rbgs11jan.jpg


Tribulus Leaf supports normal reproductive

function in men and women also a male tonic: libido and

performance menopausal symptoms

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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: Raffi Kojian/http://Gardenology.org/ CC-BY-SA-3.0 / https://commons.wikimedia.org/wiki/File:Starr_030612-0063_Tribulus_terrestris.jpg

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Andrographis short-term immune system

support upper respiratory support non-cystic acne

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Image: J.M.Garg / Creative Commons Attribution-Share Alike 4.0 International https://commons.wikimedia.org/wiki/File:Andrographis_paniculata_(Kalpa)_in_Narshapur_forest,_AP_W_IMG_0871.jpg


Echinacea Root immune system support useful as well for treatment,

but with Andrographis does not deplete the immune

system with continuous use

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Kava amazingly good for anxiety

and difficulty sleeping relaxes muscle, both smooth

and skeletal depressed mood if comorbid

with anxiety

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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: Poyt448, Peter Woodard / Creative Commons Attribution-Share Alike 4.0 International / https://commons.wikimedia.org/wiki/File:Big_leaf_plant_Lord_Howe_Island_lowland.jpg

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Rhodiola fatigue, physical stress,

convalescence depressed mood improves performance

(mental and physical)

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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: Σ64 / CC-BY-SA-3.0 /https://commons.wikimedia.org/wiki/File:Rhodiola_rosea_01.jpg


Ashwagandha as for Rhodiola previously

but for anxiety, rather than depressed mood, and is a more calming tonic

boosts DHEA, testosterone and thyroxin

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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine2nd edition, Elsevier, UK, 2013

Image: Hari Prasad Nadig, Vinayaraj / CC-BY-SA-2.0 / https://commons.wikimedia.org/wiki/File:Ashwagandha.jpg


Horsechestnut varicose vein symptoms

and hemorrhoids unexplained balance issues soft tissue compression

syndromes

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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: http://s0.geograph.org.uk/geophotos/03/00/09/3000989_a92d2f53.jpg

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St John’s Wort gold standard evidence

for low mood can be effective for

exercise-related nerve pain immune support

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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: Bob Peterson/ CC-BY-SA-2.0 / https://commons.wikimedia.org/wiki/File:Peelbark_St._Johns-wort_(Hypericum_fasciculatum)_(6439017119).jpg


Eyebright for upper respiratory system relief good also for dry, irritated eyes best combined with Golden Seal

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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: Enrico Blasutto/ Creative Commons Attribution-Share Alike 3.0 Unported / https://commons.wikimedia.org/wiki/File:Euphrasia_rostkoviana_ENBLA02.jpeg


Gymnema supports the endocrine

pancreas long- and short-term effects

on blood sugar metabolism reduces sweet cravings

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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: Slick-o-bot / CC-BY-SA-2.0 / https://commons.wikimedia.org/wiki/File:Gymnema_sylvestre_R.Br_-_Flickr_-_lalithamba.jpg

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Gotu Kola supports natural healing

by promoting connective tissue also benefits the microcirculation is a proven brain tonic varicose vein symptoms and

hemorrhoids

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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: Forest & Kim Starr / CC-BY-SA-3.0 Unported / https://commons.wikimedia.org/wiki/File:Starr_020803-0094_Centella_asiatica.jpg


Ginkgo good for focus and short-term

memory age-related cognitive decline also benefits the microcirculation

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Image: http://maxpixel.freegreatpicture.com/Ginkgo-Biloba-Fruit-Gingko-Tree-Fukushima-Tree-610016


Korean Ginseng fatigue, physical stress,

convalescence improves performance

(mental and physical) also a male tonic: libido

and performance long-term immune system support supports the heart

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Bone KM, Mills SY. Principles and Practice of Phytotherapy: Modern Herbal Medicine 2nd edition, Elsevier, UK, 2013Image: FloralFarm GmbH/Katharina Lohrie/ CC-BY-SA-3.0 Unported / https://commons.wikimedia.org/wiki/File:Ginsengpflanze.jpg

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Functional Phytotherapy

James Diedrick ?https://www.flickr.com/photos/jkdatlanta/3497413025

Roots: Thomsonian Medicine

1. Health follows from obeying natural laws

2. Disease is an obstruction or diminution of vital energy

3. It is caused by violation of natural laws

4. Symptoms, such as fever, are due to the effect of the disease and are not the disease itself

5. Disease has only one basic type of cure – to remove obstructions or restore vital energy using substances that act in harmony with natural laws and the vital energy

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Thomsonian Medicine

6. In doing so one or more of the following effects should be accomplished:

a) Relaxation

b) Contraction

c) Stimulation

d) Soothing

e) Nourishing

f) Neutralization

24Image: Lloyd, John Uri; Waterhouse, Benjamin. 1909. "Life and medical discoveries of Samuel Thomson, and a history of the Thomsonian materia medica, as shown in 'The new guide to health,' (1835) and the literature of that day". Cincinnati, O., J.U. & C.G. Lloyd/https://commons.wikimedia.org/wiki/File:Samuel_Thomson.jpg / PD-US

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Physiomedicalism

• Physiomedicalists were neo-Thomsonians

• Thurston (1900) was greatly influenced by the research findings on the autonomic nervous system

• He extended basic concepts into an elaborate therapeutic system (somewhat inaccessible to the modern reader)

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Functional Medicine

• Addresses the underlying causes of disease

• Uses a systems-oriented approach

• Is patient-centered rather than disease-centered (the whole person, not just an isolated set of symptoms)

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www. functionalmedicine.orgImage: https://c1.staticflickr.com/7/6207/6052491503_c719b2a6b3_b.jpg

Functional Medicine

• History together with genetic, environmental and lifestyle factors are paramount: the matrix

• Supports the unique expression of health and vitality for each individual

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1. Understanding diseases as disordered processes of normal physiology

2. Mosaic diseases: the individual story counts most

3. Complex interventions for complex multifactorial disorders (network pharmacology)

4. Therapy based on 12 core strategic targets

5. But the key over-riding consideration is to support the tissue

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Mosaic Disease

• Concept first proposed by Irvine Page in 1950 in the context of hypertension1

• Later in 1989 Yehuda Shoenfeld coined the term for autoimmune disease (AiD)2

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1.Page IH. Hypertension 1982; 4(2): 1772.Shoenfeld Y, Isenberg DA. Immunol Today 1989; 10(4): 123-126

Mosaic Disease Principles

• A syndrome or disease differs in expression shares many common factors (pieces or tiles)

• Each piece is a causative factor in the disease

• Each patient is a unique picture

• Due to the random (stochastic) combination of causative factors

• THE PATIENT’S STORY IS PARAMOUNT

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The Three P’s of Causation

Predisposing – e.g. genetics

Precipitating – e.g. pathogens

Perpetuating – e.g. maladaptive stress response

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Applying the OST Rule

Overlap therapeutic activity use complex treatments

Sequence treatments not everything at once

Triage set priorities

32Image: UVM Scribe/ CC-BY-SA-3.0 / https://en.wikipedia.org/wiki/File:UW_surgery_and_residents.jpg

Complex Interventions for Complex Disorders

• Multiple factors require multiple interventions

• Determined for each patient by their case history

• Targeting just one point in a pathophysiological network and completely shutting it down risks side effects and does not resolve the disease

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Herbs as Inherently Complex Interventions

• Gertsch observed that herbal extracts might be complex but are in fact “intelligent mixtures” of secondary plant metabolites shaped by evolutionary pressures

• He notes the concept of network pharmacology, as originally proposed by Hopkins

34Gertsch J. Planta Med 2011; 77(11): 1086-1098


The 12 core strategies1. Support key endocrine responses:

• HPA axis• thyroid• pancreatic beta cells• enteroendocrine cells• male/female as appropriate

35Image: BrianMSweis/ CC-BY-SA-3.0 Unported / https://commons.wikimedia.org/wiki/File:Brian_M_Sweis_HPA_Axis_Diagram_2012.pdf


2. Eliminate naturally occurring pathogens

3. Protect and re-energize cells • boost cellular protection (cytoprotection)• lower danger signals• enhance mitochondrial function and biogenesis

4. Detoxify and prime Nrf2 responses

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5. Enhance nerve function• restore healthy nervous system function• improve sleep quality and time asleep

6. Improve circulatory flow• macrocirculation and blood quality• microcirculation and endothelial health• promote healing

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7. Eliminate dysbiosis and promote a healthy microbiome

8. Optimize digestive function

9. Optimize and balance immune function

10. Eliminate chronic inflammation response

38Image: Tony Webster/ https://www.flickr.com/photos/diversey/17424310262


11. Improve and enhance natural barriers: • gastric acid and gut wall

barrier• respiratory• skin

12. Address metabolic imbalances

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Bone K, Mills S. Principles and Practice of Phytotherapy 2nd Edition, 2013, Elsevier, Edinburgh

Right Targets:Lead to Right Protocols

Concluding Remarks

• Even a novice can achieve remarkable results with symptom-based prescribing, especially if using herbs that deliver in formulations with inbuilt clinical experience

• The next step is functional phytotherapy: 12 core strategies and 5 key principles, with some introductory examples, have been outlined

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Functional Phytotherapy for Clinical Success · textbooks on herbal medicine, including his latest,...

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