by Dr. Josh Axe
Honorable mention: Galangal (a stem plant similar to ginger), ginger, rosemary, and skullcap.
The first-rate heart and blood protectors
Your heart and blood are life-giving. Protect them from disease with these two ancient herbs.
Dong quai. In TCM, this is one of the most recommended herbs for women. It’s the number one herb for strengthening blood to fight anemia, a top five herb for balancing hormones, and it is known as female ginseng because of its ability to boost energy. This herb can also lower blood sugar, thereby helping to prevent diabetes. Research published in the journal Food and Function showed that mice who were given dong quai for four weeks had lower blood sugar levels and better insulin function.39 Likewise, the same study showed that treating mice with dong quai for four weeks decreased their levels of total cholesterol as well as triglycerides—an outcome that can help prevent heart disease. And dong quai may be beneficial for those with high blood pressure, another heart disease risk factor. Take 2 to 4 grams of a supplement, divided into three doses, per day.
Hawthorn. Often called the “heart herb,” hawthorn is prized for its ability to treat heart-related ailments, an ability that probably stems from its high antioxidant content. Studies have found that it can lower blood pressure, treat angina, reduce cholesterol, and treat patients with heart failure. In a paper published in Preventive Cardiology on herbs for the treatment of heart disease, the author, a researcher from George Washington University School of Medicine, highlighted hawthorn’s benefits for those with congestive heart failure.40 If you don’t have a cardiovascular problem, there’s no need to take it. If you do, take up to 1,800 milligrams a day for no more than twenty-four weeks. It may take up to twelve weeks for symptoms to improve. (Don’t take hawthorn if you’re pregnant or breastfeeding, and don’t give it to children.)
Honorable mention: Peony, reishi, cinnamon, holy basil, turmeric, and green tea.
The age-old hormone balancers
Hormones govern everything from mood to menstrual cycles, fertility, and metabolism. Keeping them at healthy levels can help your body function optimally. Here are four herbs that shine in this realm.
Ashwagandha. A potent adaptogen, this herb is great at balancing hormones. If you have low thyroid (hypothyroidism), ashwagandha can normalize it. If you have high blood sugar or high cholesterol, ashwagandha can lower it. It has the same balancing effect on stress, anxiety, and depression—all of which are controlled by hormones. Take 300 to 500 milligrams per day of a supplement that contains 5 to 10 percent withanolides (naturally occurring hormones). Many supplement instructions suggest taking between 1,000 and 1,500 milligrams per day, but work your way up to that.
Vitex. One of the most popular herbal remedies for PMS and cramps, vitex helped decrease PMS-related complaints in 93 percent of study subjects according to a paper published in the Journal of Women’s Health and Gender-Based Medicine.41 Vitex (also known as chasteberry) can also improve fertility. In one double-blind, placebo-controlled trial, researchers from Stanford University School of Medicine gave fifty-three women who had tried unsuccessfully to conceive for six to thirty-six months an herbal blend containing vitex, as well as green tea, vitamins, and minerals, while forty women received a placebo. The menstrual cycles of the women taking the vitex blend normalized, and fourteen of the women (26 percent) became pregnant within three months, while another three conceived after six months. On the other hand, only four of the women in the placebo group got pregnant.42 There’s also evidence that vitex treats endometriosis, amenorrhea, and menopause symptoms and supports healthy milk production in breastfeeding women. It can also inhibit the proliferation of prostate cancer cells in men. For PMS, take 400 milligrams a day before breakfast. For infertility and menopausal symptoms, take 160 to 240 milligrams a day. For endometriosis, take 400 milligrams a day.
Fenugreek. This herb, which increases sexual arousal and testosterone levels, is used to treat hernias, erectile dysfunction, and male pattern baldness. When Australian researchers gave thirty healthy men a fenugreek supplement, they found a positive effect on their sexual arousal, energy, and stamina. They also found that the supplement helped participants maintain normal testosterone levels.43 The herb also seems to support healthy milk flow in breastfeeding women who are experiencing low milk supply. Take 600 milligrams of fenugreek seed extract every day.
Black cohosh. This herbal remedy contains phytoestrogens—plant-based estrogens—and, as a result, is known for its ability to treat hormonal issues, including the symptoms of menopause. Indeed, a recent study in eighty postmenopausal women with hot flashes found that over eight weeks, black cohosh was able to significantly reduce the severity and frequency.44 The herb can reduce hot flashes in breast cancer survivors as well. What’s more, it can improve your sleep during menopause, according to a randomized, double-blind, placebo-controlled trial published in Climacteric.45 Getting plenty of rest is also vital to balancing hormones naturally. Take 160 to 200 milligrams a day.
Honorable mention: Clary sage, wild yam for women, and ginseng and epimedium (also known as horny goat weed, used to treat erectile dysfunction) for men.
The super system-wide detoxifiers
Toxins, pesticides, preservatives, and additives all make their way into our bodies, and the liver is the organ responsible for clearing them out. These three herbs support the liver’s ability to remove these unwanted contaminants.
Milk thistle. This herb, also known as silymarin, is used for everything from weight loss to skin health—but it’s best known for providing natural support for the liver. Indeed, it’s the most well-researched plant in the treatment of liver disease, like cirrhosis, jaundice, and hepatitis.46 Milk thistle cleanses the liver by rebuilding liver cells, reducing damage, and promoting toxin removal, one of the liver’s main functions. What’s more, laboratory studies have shown that it suppresses cellular inflammation by activating cell repair pathways.47 To detox the liver, take 150 milligrams one to three times a day. For ongoing liver support, take 50 to 150 milligrams daily.
Bupleurum. In TCM, this herb has long been relied upon for liver detoxification, and new research helps explain why it’s so effective. In a laboratory study, researchers from Bulgaria identified two potent antioxidants, narcissin, and rutin, in bupleurum and tested their effect on liver cells. What they found: Narcissin and rutin protect the liver on both the cellular and subcellular levels by limiting the damage caused by free radicals, unstable atoms that can damage cells, leading to illness and aging.48 Bupleurum is available in pill or liquid form and is included in a number of liver formulas that also include other herbs like milk thistle and dandelion root. Take as directed.
Dandelion root. Like bupleurum, dandelion root is rich in antioxidants, which probably helps account for its protective benefits to the liver. But research has revealed other promising liver-saving mechanisms associated with dandelion root. In a study published in the journal Molecules, researchers gave mice polysaccharides (long chains of carbohydrate molecules) extracted from dandelion root and found that the substance protected the rodents’ livers from acetaminophen-induced liver injury.49 What’s more, dandelion root seems to increase the flow of bile, which is essential for breaking down fats. Most dandelion root supplements and extracts contain 500 to 1,500 milligrams per serving. As with any supplement, start with the lowest dose to see how it makes you feel.
Honorable mention: Artichoke, cilantro, cypress, gentian (an herb known for its ability to help with digestive problems), turmeric, and seaweeds, like chlorella and spirulina.
The time-tested sleep-well solutions
Whether due to stress, menopause symptoms, anxiety, depression, or chronic pain, insomnia hits all of us at some point, leaving us wiped out and vulnerable to everything from weight gain to car accidents. Here are three plant-based remedies that can help you get a good night’s sleep.
Valerian. Research shows that valerian reduces the time it takes to fall asleep and improves sleep quali
ty. In one double-blind study, Swedish researchers found that a valerian-based supplement helped improve sleep in 89 percent of participants.50 Another randomized, triple-blind trial in the journal Menopause found that valerian extract improved the quality of sleep.51 Valerian bolsters sleep by increasing the brain’s level of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits the central nervous system. Valerian has also been shown to calm anxiety. To improve sleep, take 1 teaspoon of a valerian tincture or fluid extract daily. It can take two weeks for the effect to take hold. Once sleep improves, keep taking valerian for two to six weeks.
Chamomile. You might already know that a cup of chamomile tea before bed can calm you down and set the stage for sleep. One reason for this is that it reduces anxiety. Indeed, a study trial of chamomile in people with moderate to severe anxiety found a meaningful reduction in anxiety symptoms over eight weeks, with a response rate similar to pharmaceutical treatments for anxiety.52 Try a cup or two of chamomile tea before bed. For greater benefit, take between 220 and 1,600 milligrams of a chamomile supplement instead.
CBD. Cannabis has been used for relief for thousands of years, and cannabidiol (CBD), a non-euphoric component of cannabis, has experienced an enthusiastic resurgence in the past few years. There’s a good reason for this: CBD is a potent anti-inflammatory that may help cut the risk for dozens of diseases. You’ll learn more in chapter 7, but for now I’ll touch on one important benefit: CBD can help you sleep because, among other things, it calms the central nervous system. In a study published in the Permanente Journal, researchers at the University of Colorado observed people with anxiety or poor sleep who were treated with CBD. Within the first month, nearly 80 percent of patients with anxiety showed reduced anxiety scores, and sleep scores improved in 67 percent.53 Because CBD is relatively new, dosing isn’t clear, but in the Colorado study, patients were given 25 to 75 milligram capsules of CBD every day. For anxiety, patients took it in the morning after breakfast. For insomnia, they took it every evening after dinner.
Honorable mention: Lavender, lemon balm, linden, passionflower, and poppy seed.
This should give you a good introduction to the many ways plant-based medicinals can improve your health. There are literally hundreds of options to choose from—many of which are barely known in the United States. In upcoming chapters, you’ll learn more about how to use these ancient remedies to treat a variety of conditions—and improve your overall health.
CHAPTER 7
Cannabis: The Forbidden Herb
The Medication That Pharmaceutical Companies Want to Keep for Themselves
Several years ago, a sixty-year-old man named John came to see me at my functional medicine practice. His daughter, Amy, brought him in because she was worried about him. He had been on antidepressants and opioids for ten years to treat chronic back pain, she explained, but the medications had changed him. “He used to be fun and encouraging and engaged,” she told me. “Now he’s robotic and withdrawn.”
I felt for them, and I was honest with them. Getting John off the medications wouldn’t be easy, I said, and we’d need to do it very slowly, dropping the dosage by tiny increments. What’s more, he’d need to participate in the process by adopting some dietary and lifestyle changes. He agreed to try.
I gave him dietary recommendations, including milk thistle, to start moving energy and blood through his body again because his liver had become sluggish from the antidepressants, a common side effect. I also suggested he use the scent of citrus essential oil to lift his mood and prescribed yoga and nature walks to support his liver. But none of it would work unless we could address his pain. And for that I recommended topical CBD (cannabidiol) oil. CBD, a non-euphoric substance in the cannabis plant, not only supports the movement and healthy flow of qi, but it is also an effective pain reliever that fights inflammation.
The process of getting John off the drugs took two painstaking years. But he eventually did it. Along the way, his personality slowly returned, and he was even able to play golf again, a sport he’d loved before his back problems started. When I chatted with him toward the end of the process, he told me the thing that helped the most was the CBD. It reduced his pain, he said, adding, “I think it saved my life. If it hadn’t been for that, I’d still be on the drugs.”
Chances are, you think of CBD as a modern phenomenon. But here’s the truth: Humans have been using this remedy for healing for millennia. In 2900 BC, Chinese emperor Fu Hsi wrote a Chinese medicine textbook in which he observed that the popular substance ma (the Chinese word for cannabis) contains a blend of both yin and yang. Some 250 years later, Chinese emperor Shen Nung began explaining the healing properties of the herb, including pain relief, sleep, and reducing inflammation and anxiety.
CBD is what’s known as a cannabinoid, the name for the therapeutic substances found in the cannabis plant. Research shows there are hundreds of cannabinoids. Some of them, including CBD, are found in hemp, a type of cannabis plant that has been used for thousands of years to make products like paper, clothing, rope, fabric, and building materials. In fact, the Gutenberg Bible, the world’s first book printed on a moveable printing press, in 1454, is printed on paper made from hemp.
Today, by law, hemp doesn’t contain any cannabinoids that have euphoric effects, as opposed to marijuana, a similar type of cannabis plant, which contains varying levels of tetrahydrocannabinol (THC), the cannabinoid chemical that can make someone feel high. As a result, the CBD oils and tinctures on the national market in the United States are made primarily from the leaves and flowers of the hemp plant.
References to the medical use of the cannabis plant have cropped up around the world throughout the ages, from India’s ancient Ayurvedic medicine to records from Greece dating back nearly two thousand years. And this fact might really surprise you: For many years, cannabis was a commonly used medicine in the United States. In fact, in the 1800s, doctors considered it so safe that it was marketed to new moms to relieve babies’ teething pain.
Then, in the 1930s and ’40s, the United States government began stoking fears about the dangers of cannabis, and the United States and other countries banned the substance. In 1970, the United States government tightened cannabis restrictions even more drastically by passing the Controlled Substances Act, which classified the cannabis plant, along with all the cannabinoids it contains, including CBD, as a Schedule 1 substance—a category that also includes high-risk drugs, like heroin and methamphetamine.
The Controlled Substances Act also specified that drugs in this category have no known medical uses—including cannabis. That’s like saying exercise has no medical value. And it’s especially ironic, because just five years later a study in the Journal of the National Cancer Institute (which at the time was published by the government’s National Cancer Institute), found that using cannabinoids to treat lab animals with lung cancer inhibited the tumors’ growth.1
Fortunately, the legal status of cannabis is undergoing a transformation. As of this writing, thirty-three states and the District of Columbia have legalized medical cannabis (both marijuana and hemp). Meanwhile, as I mentioned in chapter 1, CBD derived from hemp, but not other forms of cannabis, is now legal on the federal level. Even so, research into CBD and other cannabinoids’ medical uses has been badly hampered by the federal government’s marijuana regulations.
That’s a shame, because most studies that have been conducted show that CBD and other cannabinoids can be beneficial if they are used in the correct ratio and dosage to replace synthetic medications—and it’s likely we’ve just scratched the surface of their potential. Preliminary research has bolstered the hopeful idea that CBD and other cannabinoids can shrink cancerous tumors, for instance.2 Other studies show they may arrest Alzheimer’s plaque formation3 and slow the progress of concussion-related brain disease.4 And a number of studies have demonstrated that CBD can reduce anxiety, improve digestion, curb nausea, aid sleep, boost brain health, and relieve chronic pain and infla
mmation. And, as I mentioned in chapter 1, in 2018 the US Food and Drug Administration approved the first-ever CBD-derived drug, Epidiolex, designed to treat children with intractable seizure disorders.
The majority of healthcare professionals support the legalization of medical cannabis,5 and doctors across the country—including the Knox Docs (Rachel, Jessica, Janice, and David Knox), a family of four physicians pioneering the field of cannabinology—are helping patients understand how to use it safely and effectively. And two high-profile MDs—CNN’s chief medical correspondent Dr. Sanjay Gupta and Dr. Mehmet Oz—have become vocal advocates for medical cannabis, partly due to compelling evidence showing that states where medical cannabis is legal saw a 20 percent decline in opioid-related overdose deaths from 1999 to 2010.6 (In 1996, California was the first state to legalize medical cannabis, and the trend quickly spread.)
Furthermore, patients say cannabinoids work. In a survey published in Drug and Alcohol Review, 92 percent of medical cannabis patients said the substance alleviated their symptoms, including chronic pain, arthritis, migraines, and cancer.7 Ironic, isn’t it? A substance our own government still demonizes as dangerous is, at this very moment, safely providing extraordinary relief for millions of people.
I want to be clear. I’m not endorsing the use of recreational marijuana—or even long-term use of medical marijuana containing THC, the intoxicating component of the plant. But I believe that hemp-based CBD and other cannabinoids, like cannabigerol (CBG) and cannabinol (CBN), have enormous potential for improving your health—and they’re an integral component of my ancient remedies program. As a result, it’s important to me that you understand what cannabinoids are and why they work. With that in mind, the following sections explain the life-saving biological system that allows us to respond to cannabis, as well as the plant’s most promising chemicals, and the research supporting its extensive—and remarkable—benefits.