Stages of life – Herbal Reality

Codonopsis

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Wormwood

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Shepherd’s purse

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Irish moss

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Aniseed

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Rose geranium

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Chaga

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Tremella

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Mugwort

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Lion’s mane

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Chilli peppers

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False unicorn

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Yarrow

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Garlic

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Vervain

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Schisandra

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Maca

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Children’s health: ADHD

Jessika Thiele — Sat, 17 Sep 2022 16:10:05 +0000

Just like with adults, children’s health can be varied and complex, as children can be affected by physical and emotional issues as well as neurological wiring.

Understanding ADHD and children

Children’s behaviour can be affected by emotional and physical issues, or their neurological wiring. Physical problems will often affect a child’s behaviour, and perhaps especially when they are not able to express themselves verbally this may be interpreted as behavioural issues before the root of the behavioural change is discovered.

If changes to a child’s behaviour are observed over a prolonged period, it is advisable to seek professional help, to assist in assessing the root cause of any problems.

How does children’s hyperactivity, behaviour and ADHD work?

The foundation of neurotypical children’s behaviour is largely formed through the input they receive from the environment surrounding them. This primarily consists of care-givers behaviour (this can include parents and other care-givers), including the type of nurturing, whether and how they communicate love to a child, provision of learning and play experiences, disciplinary techniques used, and behaviour as role models (1,2).

Alongside this, the dietary intake of a child has, in numerous ways, been shown to have an impact on their behaviour. For example, eating refined sugar products often leads to hyperactive or disruptive behaviour (3); a ‘sugar challenge’ of a high carbohydrate breakfast (consisting of sugar-coated cereal, milk, and orange juice) has been shown to reduce the attention span of hyperactive children and those who were not previously labelled as hyperactive (4). There is also a suggestion that artificial flavours and additives in food may be a contributing factor for hyperactivity in children (3,5).

This is just one small example of how children are prone to behavioural changes often due to external factors such as diet, and behavioural issues may be difficult to resolve unless appropriate changes to these underlying factors are also implemented.

However attention-deficit/hyperactivity disorder has different root causes as it is the wiring in the child’s brain that affects their behaviour, and has much less to do with environmental factors.

ADHD is the most common disorder affecting behaviour and is estimated to affect between 5 – 15% of children, however some experts believe that it is over-diagnosed as differentiating between ADHD and other conditions can be challenging (7). Onset often occurs before age 4 and invariably before age 12. The peak age for diagnosis is between ages 8 and 10.

ADHD used to be considered a behaviour disorder, probably because children typically exhibit inattentive, impulsive, and overly active behaviour, whereas now it is considered a neurodevelopmental disorder. Neurodevelopmental disorders are neurologically based conditions that appear early in childhood typically before school entry. They impair development of personal, social, academic, and/or occupational functioning.

Current treatment of ADHD

Conventional drug-based treatments for the symptoms of ADHD have side effects, and doses often need to be adjusted to find a balance between reducing symptoms so that daily life is not disrupted but ensuring that medication side effects also do not disrupt daily life.

ADHD is categorised in three types according to the prevalent behaviour involved:

Inattention
Impulsivity
Hyperactivity

Many patients will have more than one of these which is classed as combined ADHD.

It is important that children with hyperactive behaviour or ADHD receive support and treatment, because one factor which prevails for many children with ADHD is not being able to cope well with school. This is not because of the academic abilities of a child but rather the way that schools are set up to have a student sat, in the same seat for many hours a day focusing (a feat that many children struggle with!). Some may find it difficult to connect with peers/ having difficulty making friends, especially if they are labelled disruptive. This can then lead to social isolation.

Understanding the root of ADHD

There are various contributing factors to ADHD, and more is now being understood about the brain chemistry that causes it. This section explains the neuroscience as well as other possible contributing factors that can cause ADHD or make symptoms worse.

The neuroscience of ADHD

The brain is full of different regions all with different functions. In people with ADHD different regions have formed differently to neurotypical people. A study shows that people with ADHD have smaller anterior cingulate cortex’s (ACC), and that that are formed differently (2). “The anterior cingulate cortex (ACC) is a central brain node for the integration of cognitive control and allocation of attention, affect and drive. Thus, its anatomical alteration may give rise to impulsivity, hyperactivity and inattention, which are cardinal behavioural manifestations of ADHD”. The anterior cingulate gyrus is a part of this, and is involved in sociability and behaviour. It is also an important regulator of other brain regions, and its disconnection seems to be consistent with the symptoms encountered in ADHD (12).

More analysis of imaging studies across 23 sites in more that 1713 ADHD patients and 1500 controls found volume reductions in the insula, the basal ganglia, and in limbic areas such as amygdala and hippocampus (13). These regions of the brain affect many different behaviours and cognitive processes such as sustained attention, response variability and cognitive switching. This can explain why people with ADHD often have the ability to switch rapidly between topics in conversation and work.

Science is now showing that children with ADHD are not merely hyperactive, rather that is the result of the neurology of their brain. Therefore whilst symptoms can be supported and quality of life significantly improved, ADHD can not be cured. It is also important to note that whilst ADHD can certainly cause problems for people sometimes, people living with ADHD may have a variety of skills and abilities beyond those of their neurotypical counterparts. For example, people with ADHD can often experience hyperfocus, high levels of creativity, good conversational skills, spontaneity and lots of energy.

There has also been a link between dopamine and ADHD. Dopamine levels are implicated in a person’s mood, attention, movement, motivation and reward. Dopamine transporters remove dopamine from the brain cells, and people with ADHD may have a higher concentration of dopamine transporters in the brain. When there are too many transporters in one region, dopamine is removed too quickly and so has less time to exert its effects.

Other potential contributing factors

Despite much more neuroscience research being conducted, there is still no specific cause identified for ADHD. It is believed to be a combination of genetic, biochemical, sensorimotor, physiologic, and behavioural factors being suggested, and it is sometimes associated with adverse childhood experiences.

Some risk factors for ADHD include (7):

Low birth weight (< 1500 g)
head trauma
iron deficiency
obstructive sleep apnoea
lead exposure
prenatal exposure to alcohol, tobacco, and cocaine

The nervous system can also be depleted by emotional stress, which can contribute to symptoms of ADHD by increasing the body’s use of vital nutrients. Therefore, understanding if there are any factors which may be contributing to a child’s emotional stress is also important in getting to the root of the problem.

Links between accumulation of heavy metals in the body and ADHD have been hypothesised (3, 5), since diagnosis of the condition has become something of a phenomena coinciding with the growth of global pollution of air, water, and food systems. Increased diagnosis could be due to increased understanding of this condition, but intoxication with certain heavy metals has been linked with neurological changes which result in increased impulsivity and addictive behaviour (8).

A study of over 2000 children in an area of Chile where there is reported heavy metal contamination, and arsenic in the water, found that children with higher levels of blood lead concentrations were significantly more likely to develop ADHD compared to children with lower levels of lead toxicity (9). This study is not conclusive evidence of heavy metal toxicity being a direct cause of ADHD due to potential other variables being involved, but certainly suggests that it may well be a contributing factor in the likelihood of developing ADHD.

Diet and nutrition

It has long been clear that food allergies or intolerances are one frequent reason for behavioural changes in neurotypical children which can result in trouble sleeping, temper tantrums, aggression, and mood swings. Inevitably, this will affect children with ADHD too and can worsen their symptoms. Hypoglycaemia (low blood sugar) can also cause mood swings and erratic behaviour in children, which can occur with the over-consumption of sugar and refined carbohydrates (3).

The gut-microbiome consists of natural bacteria which live in our digestive tract and help to keep our internal environment in harmony. There is now an increasing understanding of the important link between these gut-microbes and many aspects of health. The gut-microbiome is considered a part of the unconscious system regulating behaviour, having a major impact on cognitive function and behavioural patterns, and in their absence profound alterations in neurochemistry are observed (10).

Nutritional deficiencies are also a cause of disrupted nervous system function, which in themselves can also predispose to food allergies. Nutritional deficiencies often stem from a diet high in sugar, refined foods, and low in vegetables and fruit (3), an often typical ‘Western diet’.

Since the gut microbiome thrives on a variety of plant-based whole-foods (vegetables, fruits, grains, nuts, seeds, fermented foods such as sauerkraut, kimchee, kefir), this suggests a link between diet and nutrition, increased tendency for food intolerances and allergies which in turn will lead to inflammation. This causes further difficulties absorbing nutrients, and results in a lower level of gut microbes, all resulting in the greater likelihood of behavioural problems in children.

A study looking at the Mediterranean diet and ADHD diagnosis found that out of 120 children / adolescents (60 with an ADHD diagnosis and 60 in a control group without diagnosis), lower adherence to a Mediterranean diet was associated significantly with ADHD diagnosis. It also found that consuming less fruit, vegetables, pasta, skipping breakfast, and eating fast foods were associated with ADHD diagnosis, however sometimes behavioural problems and ADHD can be conflated hence causing misdiagnosis. High consumption of eating sugar, candy, cola beverages and other soft-drinks, and low consumption of fatty fish were also associated with higher prevalence of ADHD diagnosis (11). This suggest that a balanced whole foods diet (rather than specific nutrients) is likely to be beneficial in preventing and / or treating ADHD. However as stated earlier it is important to note that sometimes ADHD diagnosis can be incorrect, as it can be difficult to distinguish between other conditions.

Another study looked at eliminating food components by using the Oligoantigenic Diet (OD) which led to a reduction of ADHD symptoms for more than two-thirds of patients (6). The aim of this study was to reveal how to identify foods having an impact on ADHD symptomatology. After four weeks of elimination diet the individual food sensitivities were identified in a reintroduction phase. Twenty-seven food sensitivity reactions were identified. Most of the participants were sensitive to more than one food. In all patients, ADHD symptoms were intensified by various foods during the food challenge after elimination phase. An example is that 70% of children reacted to milk products, and of these 73% did not react to dairy products which were free from lactose. This sample size was small with only 16 participants completing the study, and whilst it does not identify specific allergens which may trigger ADHD, it does suggest that children with ADHD diagnosis and no previous sign of food intolerances (as in this study), would benefit from exploring elimination diets to understand if food may be causing reactions and stimulating ADHD symptoms.

This offers a perspective on ADHD which suggests that although root causes are not clear, there is great scope to potentially reducing symptoms with dietary adjustments towards whole food diets and through elimination diets to discover potential intolerances. This is particularly important because of the side effects of medication which do not really resolve the root cause of the condition, and also because of the potential long-term consequences going into adolescence and adulthood if the condition is left undiagnosed and / or untreated. Whilst these lifestyle choices can not cure the condition, they can significantly improve quality of life. Herbalism can also really offer hope in providing support.

Signs and symptoms

These criteria requires more than 6 symptoms and signs from one or each group. Also, the symptoms need to:

Be present often for ≥ 6 months
Be more pronounced than expected for the child’s developmental level
Occur in at least 2 situations (eg, home and school)
Be present before age 12 (at least some symptoms)
Interfere with functioning at home, school, or work

Inattention symptoms:

Does not pay attention to details or makes careless mistakes in schoolwork or with other activities
Has difficulty sustaining attention on tasks at school or during play
Does not seem to listen when spoken to directly
Does not follow through on instructions or finish tasks
Has difficulty organizing tasks and activities
Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort over a long period of time
Often loses things necessary for school tasks or activities
Is easily distracted
Is forgetful in daily activities

Hyperactivity and impulsivity symptoms:

Often fidgets with hands or feet or squirms
Often leaves seat in classroom or elsewhere
Often runs about or climbs excessively where such activity is inappropriate
Has difficulty playing quietly
Often on the go, highly energetic
Often talks excessively
Often blurts out answers before questions are completed
Often has difficulty awaiting turn
Often interrupts or intrudes on others

Herbal solutions

The herbal treatment of ADHD and hyperactivity will need to be implemented alongside the relevant dietary and lifestyle changes such as eliminating junk food and replacing with nutritious whole foods diet, parental or caregiver support in how to implement and sustain this, as well as relevant emotional support for child and caregivers. It is recommended to seek professional guidance from a herbalist for complex conditions, and also it must be noted that this is for symptom management not a cure.

Nervous system support

Supporting the nervous system would be the main herbal approach in cases of children experiencing hyperactivity and behavioural issues, to help relieve the stress involved, and also nourish and support the nervous system to function well. Nourishing nervines and adaptogens will help and increase resilience to this stress, and reduce feelings of anxiety which may be present.

Skullcap (Scutellaria lateriflora)

Nervous system tonics

Vervain is helpful to re-establish healthy sleep patterns and is energetically grounding helping to calm energy down. It can be given throughout the day during periods when a child becomes run-down from lack of sleep (3), until a healthy sleeping pattern is re-established.

Skullcap is helpful in cases of overthinking or ‘busy head’. It can be taken as an infusion before bed for cases of insomnia.

Rose is particularly helpful for calming irritability and anger. It restores the nervous system and is helpful in insomnia. For children a strong infusion or essential oil can be added to a bath before bed.

Oats are a nutrient for the nervous system, and a tonic nervine action, so toning and restoring the nervous system. Oat straw and oat seed are highly recommended.

Liquorice will support adrenal gland function and so responses to stress, though caution must be taken if one has high blood pressure.

Ashwagandha for adaptogenic support, to increase resilience to stress, balance hormones and to nourish the nervous system.

For sleep issues include: catnip, lime flower, as a tea before bed. Also as a strong infusion can be added to the bath water.

For children who are particularly tense and prone to temper tantrums and angry outbursts, chamomile, lime flower, tulsi, rose, skullcap, and liquorice can be beneficial.

Aid support of heavy metal elimination

Red clover is a relaxant and also has blood purifying properties so is helpful for eliminating heavy metals from the body, along with charcoal, kelp and nettle.

Ayurvedic perspective

From an Ayurvedic perspective, ADHD is likely a disorder associated with imbalance of Vata and Pitta, and so herbs will be given to support balance of these Doshas.

Vata reducing herbs for cases of a nervy, restless and easily distracted child: ashwagandha, wild oats, gotu kola, shatavari.

Sweet flag (Acorus calamus)is used by Indian doctors as a brain tonic and for memory problems (3). Interestingly from a western herbal perspective it is considered a healing tonic for the whole gastro-intestinal tract where it has a soothing and toning effect, whilst also bitter components will promote digestive function and appetite, and digestive support may well be indicated in most cases of ADHD.

Pitta calming herbs are used in cases of aggression and anger, including gotu kola, chamomile, coriander, shatavari.

Bacopa and gotu kola will also potentially help with memory, as may ginkgo biloba.

Holistic solutions

Dietary

Based on all the points discussed regarding diet and ADHD, paying attention to a balanced nutritious whole-foods diet is likely to be beneficial in managing symptoms of ADHD or general hyperactivity.
Ensuring regular meals to avoid hypoglycaemia and checking that the child is eating during the school day.
Trying an elimination diet and reintroduction may also be helpful in establishing any connection between food intolerances or allergies and ADHD.
Reducing or cutting out refined sugar and junk foods for one month initially may be beneficial to establish change in behaviour.
A B-vitamin complex may also be beneficial for additional nervous system support. In a trial, it has been shown to be more effective, safer, and less expensive than treatment with Ritalin (4).

Family support in the form of behavioural management may be beneficial for the whole family in terms of finding strategies to help cope with the behaviours. Also sharing constructive creative activities between parent and children such as painting, crafts, singing, story-telling can be great to enforce positive behaviour and help build bonds between children and parents / caregivers (3).

Additional supportive practices such as physical exercise, Yoga, meditation, and breathing exercises may all help to calm the nervous system and relieve stress therefore reducing symptoms of ADHD.

References

Britannica. Human Behaviour, Development in Childhood. https://www.britannica.com/topic/human-behavior/Self-concept-or-identity. Accessed 21 August, 2022.
Kopp CB, Self-Regulatory ProcessesIn: Haith MM, Benson JB, eds. Encyclopedia of Infant and Early Childhood Development. Elsevier Inc.2008: 102-117. https://doi.org/10.1016/B978-012370877-9.00140-7. Accessed 21 August, 2022.
Minsky BC. Our Children’s Health. Connecticut: Vital Health Publishing; 2002.
Hoffmann D. The New Holistic Herbal. 3^rd Edition. Shaftesbury Dorset: Element Books Ltd; 1990.
Yorgidis E, Beiner L, Blazynski N, Schneider-Momm K, Clement H-W, Rauh R, Schulz E, Clement C, Fleischhaker C. Individual Behavioral Reactions in the Context of Food Sensitivities in Children with Attention-Deficit/Hyperactivity Disorder before and after an Oligoantigenic Diet. Nutrients. 2021; 13(8):2598. https://doi.org/10.3390/nu13082598
Attention-Deficit / Hyperactivity Disorder (ADD / ADHD). MSD Manual Professional Version website. Attention-Deficit/Hyperactivity Disorder (ADD, ADHD) – Pediatrics – MSD Manual Professional Edition (msdmanuals.com). Accessed 19 August, 2022.
Pizzorno J, Murray M, Joiner-Bey H, The Clinician’s Handbook of Natural Medicine. 2nd ed. St Loius, Missouri: Churchill Livingstone Elsevier; 2008.
MP, Rubilarad P, Macarena Valdés, et al. Attention deficit hyperactivity disorder and its association with heavy metals in children from northern Chile. International Journal of Hygiene and Environmental Health: 2020;226;113483. https://doi.org/10.1016/j.ijheh.2020.113483
Dinan TG, Stilling RM, Stanton C, Cryan JF. Collective unconscious: how gut microbes shape human behavior. J Psychiatr Res. 2015;63:1-9. doi:10.1016/j.jpsychires.2015.02.021.
Ríos-Hernández A, Alda JA, Farran-Codina A, Ferreira-García E, Izquierdo-Pulido M. The Mediterranean Diet and ADHD in Children and Adolescents. Pediatrics. 2017;139(2):e20162027. doi:10.1542/peds.2016-2027
Makris N, Seidman L, Valera E et al. Anterior Cingulate Volumetric Alterations in Treatment-Naïve Adults With ADHD. J Atten Disord. 2009;13(4):407-413. doi:10.1177/1087054709351671
Rubia K. Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation. Front Hum Neurosci. 2018;12. doi:10.3389/fnhum.2018.00100

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Children’s health: An Ayurvedic perspective

Jessika Thiele — Sat, 17 Sep 2022 15:32:57 +0000

Understanding children’s health

In Ayurvedic medicine there are eight specialised branches known as Ashtang Ayurveda. The branch of Kaumar bhritya (or Baala Chikista), is equivalent to the western medical world’s paediatrics and obstetrics. It also includes treatment for fertility issues. Kaumar bhritya covers a child’s health from the time of conception to age 16 when they reach sexual maturity (1).

Kaumar bhritya is not only concerned with the physical health of mother and child but also the mental and psychological requirements of a mother and her newborn. Ayurveda understands that the mental and physical state of a mother has a direct effect on the health of the child. Kaumar bhritya recommends specific diet, routine and nourishment for women before, during and after delivery. It deals with the art of nursing, helping with purification, quantity and the quality of a mothers’ breastmilk and healthy upbringing of children (2).

How does children’s health work?

Ayurveda emphasizes that the health of a child is determined long before it is born so advocates pre-conception plans for would-be parents. This is to take advantage of the body’s natural ability to cleanse, renew, nourish and build strong ojas (vital essence and immunity) so that both parents are in optimal health to conceive a healthy baby (1).

In Ayurveda, each individual possesses a unique constitution called Prakriti. This is determined by a combination of the mother’s ovum and father’s sperm at the moment of conception. It is also influenced by the condition of the uterus, diet and behaviour of the mother (before and during pregnancy). Prakriti is a unique mix of the three doshas with usually one dosha being dominant. In Ayurveda, health declines when our unique mix of doshas becomes imbalanced. (2)

The three doshas, vata, pitta and kapha, are responsible for all physical and psychological functions in the body. They are the three primary life forces derived from the five elements (fire, earth, water, ether and air) (5).

Vata is composed of ether and air. It is the principle of movement, the energizing force of everything in the body and mind. It governs breathing, the blood circulation, pulsation of the heart, elimination of wastes. Mentally and emotionally it governs inspiration and creativity, imagination and movement of ideas in the mind (5).

Pitta is a combination of fire and water. It is the principle of transformation and heat as it is responsible for all chemical and metabolic processes within the body and mind. Pitta governs our mental analysis, digestion of thoughts and emotions, clarity and perception. It also digests nutrients to provide energy (5).

Kapha is a combination of earth and water. It is the principle of growth and protection. Kapha is responsible for the body’s nourishment and makes up the bulk of our structure, the bones, muscles, tissues, cells and body fluids. It governs strength and stability, lubrication of the mucus membranes, supports and holds the structure of the body together. On a psychological level kapha provides calmness and endurance, a sense of wellbeing, the ability to feel love, compassion and devotion (5).

Vata children

Vata dominant children tend to be lighter and have a lean build. They are usually highly creative, quick-witted and energetic. They may have dry skin or a tendency to feel cold so love the warmth and sunshine (3). Vata can suffer with anxiety, worry, mental or physical restlessness. They have an irregular appetite and are often fussy eaters with changeable moods, difficulty sleeping and sometimes constipation. Vata children benefit from meditation or mindfulness activities (2).

Pitta children

Pitta dominant children tend to have a moderate build and a sharp appetite. They need to eat regularly as can get irritable if meals are skipped. They tend to dislike hot weather as they overheat easily so should avoid activities that fire them up, opting for more mindfulness activities (2). Pitta tend towards inflammatory conditions such as diarrhoea, sensitive or easily irritated skin, sharp emotions like anger and frustration. They can feel anxious about not getting things right and failing (5).

Kapha children

Kapha predominate children have a larger and stronger build. They tend to be grounded, kind and thoughtful with a sweet nature. They dislike change or unpredictability so like to keep the status quo. They can have a tendency to be lazy as exerting themselves does not come naturally. Their appetite is stable although they aren’t usually hungry in the mornings. Their digestion is slow and sluggish but they do enjoy their food so can have an inclination to comfort eat. They sleep heavily and love to sleep late. Kapha children need to be encouraged to exercise daily and avoid cold, heavy foods (5).

The kapha stage of life

The doshas also deeply influence different stages of life. Kapha governs the first stage of life, childhood. The second stage from puberty up to the age of 50 is governed by pitta with the final stage from age 50 onwards governed by vata. The transition between stages is gradual as one dosha begins to decline while the other starts to increase (1).

The kapha stage of life begins at birth and lasts until roughly 16 years of age. Kapha is the principle of potential energy, of growth and protection that is responsible for nourishment and structure (5). Childhood is about growth, building new tissue, accumulating body mass, and rapidly increasing the weight of the physical body as it grows, all of which requires kapha. Kapha also regulates body fat which helps to provide fuel during this growth orientated period of our lives (6).

Have you ever wondered why children love sweets so much? In Ayurveda the sweet taste is building and nourishing, it produces greater strength in the bodily tissues, it improves skin complexion, strength of the sense organs and ojas (5). On a cellular level, children crave sweet, grounding, and anabolic foods that will support building and nourishing a healthy adult body and mind. It is important that children are guided to satisfying these sweet cravings in nourishing foods rather than the processed sugars complete with chemical additives found in sweets, chocolate and other easily available junk foods (1).

Understanding the root

In Ayurveda, breastmilk is the best food for a baby if the mother is eating correctly and not in a physically or emotionally traumatic situation. There are three factors that can cause mother’s milk to become indigestible for the baby (1).

Nutrition: Incorrect diet, overeating, wrong food combinations
Physical: Lack of exercise, trauma, over exertion
Psychological: Fear, anxiety, stress and anger

These factors will contribute to conditions in the baby such as colic, diarrhoea and constipation. They will also aggravate the mother’s doshas which will get passed on via the milk to the baby. If the mother has vata vriddhi the milk will cause dryness and gassiness. Pitta vriddhi will cause liquid stools and kapha vriddhi will cause excess mucus and constipation. This is the reason that ayurvedic practitioners will treat the mother first as many conditions in infants can be rectified through changes to the mother’s diet and lifestyle. Herbs can also be passed on to the baby through breast milk (2).

The kapha stage of life in childhood contributes to excess mucus, congestion, runny noses, coughs, and frequent colds. Childhood is also the time that the immune system is developing. Some immunity is acquired from the birth canal and mothers breast milk but a strong immune system is developed though exposure to various microbes. Children need to get sick in order to build a healthy immune system but they should also be able to get through colds quickly and easily (6).

Preventing excess build-up of kapha helps to reduce the likelihood of colds entering the lungs or the development of conditions such as eczema, asthma or allergies (2).

Ayurveda has always understood the importance of good digestion and a balanced agni (digestive fire) (5). Health is dependent on our ability to breakdown food, absorb and utilize nutrients. Scientific research is also validating the importance of a healthy gut microbiome and the vital role it plays in the immune system. What children are able to digest is very important to help their body build and grow to achieve optimal health and wellbeing throughout their lives (2).

In today’s world, children have access to a vast array of electronic devices. Smartphones, tablets, games and the internet which can provide education and entertainment but if used in excess contribute to many health issues (8).

Vata predominant children are especially sensitive to time spent on electronic devices. Screen time over stimulates the sense organs and nervous system increasing vata dosha. The increase in vata can then lead to sleep disturbances, anxiety, ADHD and un-groundedness (5).

A child needs to be cared for and guided so that they can develop correctly physically and mentally. A child is dependent on adults for correct diet and lifestyle choices until at least the age of 8 as children cannot yet make these decisions as their intellect is not fully functioning. Children do not need complete freedom in these areas of their life, they need structure and protection which allows them to grow to their full potential physically and mentally (1).

Ayurveda works with the cycles of life and the rhythms of the natural world in order to foster strength, resilience, and vibrant health. Children’s natural intelligence within their bodies have not yet been significantly altered by incorrect lifestyle and diet, even when there are imbalances at play, small shifts will reignite a child’s natural capacity to heal and thrive (3).

Signs and symptoms

It is important to seek medical advice if your child is very unwell.

Common childhood illnesses

Name	Common symptoms
Coughs and colds	Cough, runny nose, sneezing
Sticky eyes, conjunctivitis	Red, itchy eyes, discharge, watery, sore gritty feeling
Ear infection	Pain, discharge from ear, high temperature
Wheezing and shortness of breath	Rapid breathing or panting, rattling sound
Bronchiolitis	Runny nose, dry cough, fever
Asthma	Wheezing, coughing, shortness of breath, tight chest feeling
Constipation	Passing hard stools, straining, less than one poo per day
Diarrhoea	Watery, unformed stool,
Upset stomach	Feeling sick, vomiting, low appetite
Tics, head banging or unusual behaviour	Seek medical advice as these are often signs of an underlying issue

Herbal solutions

Always consult a qualified herbalist or ayurvedic practitioner to determine the most suitable and safe herbs, correct dosage and best method to take the herbs.

In Ayurveda for children over 1 year, herbs are usually administered in hot milk or mixed with honey or ghee. For nursing infants herbs are usually given to the mother.

Ginger (Shunthi)

Shunthi (dry ginger) is hotter and dryer than fresh ginger so is better for reducing kapha so is an excellent remedy for colds, coughs, congestion or respiratory issues. Shunthi also relives constipation, colic and increases agni. Shunthi helps with morning sickness (9). A child can suck on a small piece of fresh ginger to help soothe a sore throat (10).

Turmeric root (Curcuma longa)

Turmeric

Turmeric is a wonderful antioxidant and anti-inflammatory. It aids digestion, absorption and metabolism. Turmeric can be used for worms, bloating, colic and diarrhoea. Turmeric is one of the best natural antibiotics for a variety of infections, either viral or bacterial (1). It is also beneficial for helping with colds, coughs, sore throats and fevers (9). Turmeric helps to balance gut flora which is crucial for overall health and wellbeing (10).

Shatavari

Shatavari is useful for breastfeeding mothers as it helps increase milk production. It also enhances immunity, growth and development in babies and children. It is valued for promoting memory and metal clarity. It is used for ADHD in children combined with other brain tonic herbs. Its cooling and demulcent properties make it good for hyperacidity and diarrhoea (9). Shatavari is effective at reducing gut bacteria that in excess cause gas, bloating and colic pain (10).

Amalaki

Amalaki is one of richest natural sources of vitamin C and one of the most valued rejuvenate tonics in Ayurvedic medicine. It is particularly good as a rejuvenate following illness or stress. It balances all three doshas but primarily pitta so is good for calming anger and irritability in children from excess pitta. It is a lovely herb for children’s coughs, colds, chest infections and asthma. It is also helpful in reliving nausea, gastritis and vomiting. It is a good herb for children loving in polluted cities as Amalaki taken regularly helps to counteract the toxic effects of prolonged exposure to environmental heavy metals (10).

Bala

Bala is a strengthening rasayana which increases ojas and nourishes vata. Bala increases energy and enhances resilience to infection and stress. It soothes colic and flatulence and is good for dry coughs and asthma. Bala also helps increase milk supply in nursing mothers (9).

Liquorice

Children tend to love liquorice due to its sweet taste. It is a strengthening, nourishing and anabolic tonic. It helps increase energy and vitality. Liquorice is a very good lung tonic that is effective in treating bronchitis or any chronic lung disorder. It soothes the lungs yet expels excess mucus. Liquorice soothes irritation/inflammation so is wonderful for sore throats, dry coughs, bronchial congestion, asthma and chest infections (10).

Fennel

Fennel balances all three doshas. It improves agni without aggravating pitta. Fennel combines well with liquorice to soothe inflammatory conditions. It helps relieve indigestion, colic and cramps. It reduces kapha congestion and vata obstruction so is excellent for coughs and asthma. It also helps to increase flow of breast milk and soothes mastitis (9).

Ashwagandha

A renowned rasayana for vata (10). This is particularly good for a child with excess vata who is anxious or having trouble sleeping. Ashwagandha is an excellent adaptogen helping to support the body’s response to stress-related issues. It is good for rejuvenating weakness in children or aiding recovery post-illness. It is helpful for allergies, rhinitis and asthma caused by aggravated kapha and vata (9).

Guduchi (Tinospora cordifolia)

Guduchi

Guduchi is an excellent rasayana that enhances immunity, longevity, energy and vitality. It helps improve resilience to infections, emotional/physical stress and promotes brain function. Guduchi helps relieve respiratory infections, sinusitis, hay fever and asthma. It stimulates agni and promotes good gut bacteria (9).

Garlic oil

Olive oil infused with garlic can be used to treat ear infections. Garlic is a potent anti-microbial that also helps to soothe ear pain with its anti-inflammatory properties. Olive oil helps to soften any accumulated ear wax that has trapped bacteria (9).

Ayurveda formulas

Chyavanprash

Chyavanprash is an Ayurvedic jam which children love because of its sweetness. The main ingredient is amalaki but it also contains many other herbs, rock sugar, ghee and sesame seed oil. Its building and nourishing nature helps create strength, energy and vitality. It nourishes and protects ojas. It supports the immune function and body’s natural defences with its high vitamin C content. It stimulates healthy digestion and elimination (5).

Sitopaladi

Sitopaladi is excellent for upper respiratory congestion. It opens the airways in asthma, wheezing and hay fever. Its expectorant and lubricating actions help to clear kapha congestion and soothe the lungs and throat. It is made from bamboo, long-pepper, cinnamon, cardamom and rock candy (ayurvedic crystalised sugar) (5).

Holistic solutions

Nutrition

Children should be fed a diet that helps to keep their doshas in balance and to prevent excess kapha. Food should not be heavy or ultra-processed (5).

Replace sweets with homemade sweet treats made with jaggery. Include naturally sweet foods such as whole grains, whole milk, ghee and root vegetables (11).

Make meals interesting by using a variety of colourful fruits and vegetables (11).

Encourage more seasonal & local fruit and vegetables more than exotic ones. Avoid ultra-processed foods like frozen meals, instant pizza, canned food, carbonated drinks and, swap these with homemade items like baked sweet potato, homemade crackers (11).

Add a small number of spices like ginger, turmeric, and pepper as they help with digestion and metabolism (11).

Be flexible with your child’s choices, acknowledge that it is an exploring age for them and that appetite will vary (11).

Ayurveda considers Takra/buttermilk as one of the best probiotics. Takra is made by churning curd, diluting it with 1/4 water and add digestive spices like cumin (11).

It’s important to lead by example as parents are the biggest influencers and role models for their kids, and ultimately children imitate them.

Daily routine

In Ayurveda, daily routine is considered critical for good health and wellbeing (5). Daily routine and structure is even more important for children. Try to ensure meal times are at the same time each day. Keep bedtime, nap time and getting up times consistent. Place limits on screen time. When possible, include time for exercise each day with a nice walk in the park exploring nature or time playing outside (3).

Abhyanga oil massages

Massaging the body with warm sesame seed oil helps to calm the nervous system, lubricates and rejuvenates the tissues and promotes healthy circulation throughout the body (5). This practice is incredibly soothing to a child’s nervous system and helps to ground them from overstimulation. Apply the oil before bath time (3). Some people are allergic to sesame seeds, and so we advise you do a patch test first. For this, apply a small amount of sesame oil on a clean patch of skin, cover with a plaster and leave for 24 hours. If any irritation occurs then it means one is allergic and you should avoid using sesame oil. If irritation happens before the 24 hours then wash the oil off immediately.

Nasal rinse and nasya oil

Teaching children from a young age how to use a neti pot will create a good habit for life. A neti pot rinses the nasal passage with salt water that helps to clear mucus, debris, pollutants and allergens that contribute to respiratory issues. Teaching children how to apply nasya oil drops in their nose is also a good practice to help remove excess kapha and sinus congestion. Using a herbal nasya oil is an excellent way to direct herbs to the brain to help with calming stress, clarity and cognitive function (5).

Yoga, pranayama and meditation

Children can learn very early how to be present with their body and the power of breath. Short pranayama breathing exercises help to calm a child’s nervous system and reduce anxiety or stress. Many children love doing yoga asanas especially the poses with animal names.

Children can also learn meditation with short amounts of time focussing on counting their breaths or candle gazing. Children learn from observing adults so it is a wonderful practice to start together (3).

References

Smith, A.V.,2016. Applications of Ayurveda Treatments Throughout Life, Dietekon, Switzerland: EIVS Gmbh.
Smith, V., 2016. Anatomy and Physiology in Ayurveda Dietekon, Switzerland: EIVS Gmbh
Mischke M. Ayurveda for Kids. Banyanbotanicals.com. https://www.banyanbotanicals.com/info/ayurvedic-living/living-ayurveda/health-guides/ayurveda-for-kids/. Published 2021. Accessed August 13, 2022.
Ayurveda Tips for Children | Maharishi Ayurveda. Ayurveda-products.eu. https://www.ayurveda-products.eu/content/ayurvedic-lifestyle-and-recipes/phases-of-life/7-ayurveda-tips-for-children/. Accessed August 16, 2022.
McIntyre, A., 2012. The Ayurveda bible. Alresford: Godsfield.
Mischke M. The Three Stages of Life. Banyanbotanicals.com. https://www.banyanbotanicals.com/info/ayurvedic-living/living-ayurveda/health-guides/the-three-stages-of-life/. Published 2021. Accessed August 13, 2022.
Sunderlandccg.nhs.uk. https://sunderlandccg.nhs.uk/. Accessed August 17, 2022.
Morin A. How Too Much Screen Time Can Hurt Kids and Their Families. Verywell Family. https://www.verywellfamily.com/the-negative-effects-of-too-much-screen-time-1094877. Published 2020. Accessed August 17, 2022.
McIntyre, A, Boudin. M,.2012. Dispensing with Tradition. A Practitioners guide to using Indian and Western Herbs the Ayurvedic Way. Cheltenham. Artemis House
Smith A.,2009. A Textbook On “Dravyaguna for Westerners” Dietekon, Switzerland: EIVS Gmbh.
Varalakshmi D. Monsoon, Kids & Ayurveda with Dr. Varalakshmi Yanamandra. My World with Eira. https://myworldwitheira.com/2021/07/07/monsoon-kids-ayurveda-with-dr-varalakshmi-yanamandra-m-d/. Published 2021. Accessed August 16, 2022.

The post Children’s health: An Ayurvedic perspective appeared first on Herbal Reality.

Children’s health: A traditional Chinese medicine perspective

Jessika Thiele — Sun, 04 Sep 2022 13:29:43 +0000

Children often need some support with their wellbeing, and TCM provides ways to care for many childhood ailments safely and naturally. We explore traditional Chinese medicine ways to improve children’s health.

Understanding paediatric conditions

“fa bing rong yi, chuan bian xun su.” (Children easily become ill, and their illnesses quickly become serious.)

“zang fu qing ling, yi qu kang fu.” ([Children’s] yin and yang organs are clear and spirited. They easily and quickly regain their health.) (1 p4-5)

Children are energetically dynamic beings. While this means illnesses may take hold and flourish quickly, it thankfully also means that they can recover quickly and typically require far less intervention (including quantities of herbal aides) than adults.

How do conditions affecting children work in TCM?

As with adults, TCM treats the child as a whole, taking into account the state of their bodies, minds, spirits and lifestyle. We view their digestive, respiratory, immune and nervous systems as immature and prone to disruption. In particular, the digestive system, of which so much is asked in childhood in terms of metabolism and growth, is seen as pivotal to a child’s wellbeing. A disturbance in this area, known as the spleen/ stomach system in TCM, can and often does have a knock-on effect to all other systems. This impacts both physical and psychological processes and is found at the root of most paediatric maladies, from eczema to asthma, recurrent colds to behavioural challenges.

In particular, digestive issues impact the respiratory system in young children. This occurs in several ways. The spleen and stomach are responsible for extracting qi from the food we eat and this provides energy to the Lung system. If this process is weakened, the lungs will be, likewise. Secondly, our immunity (wei qi) is built upon energy derived from digestion and the air we breathe. Where wei qi is insufficient, the child will be prone to catching colds and these, in turn, further weaken the lungs. Finally, and perhaps most importantly, the spleen and stomach are responsible for transforming and transporting food and fluids. When this is impacted, turbidity and fluids accumulate and lead to the formation of ‘dampness’ and phlegm. In TCM we say that “the spleen is the source of phlegm and the lungs are the storehouse of phlegm”. As such, we see a direct link between typical childhood conditions such as frequent loose stools and chronic coughs or stuffy noses. We also believe that the lungs express themselves through the skin. Not only does this explain why children with skin conditions so often have concurrent digestive complaints, but also the known connection between paediatric asthma and eczema.

Needless to say, TCM views a suitable diet and sound eating habits as central to the treatment and prevention of many childhood complaints and imperative for fostering well-being and long-term health in our little ones.

Understanding the root

Some of the more common TCM paediatric patterns include:

Spleen qi deficiency

This is the primary chronic paediatric pattern that we see in western clinics and the root of many conditions in childhood. It often presents with chronic diarrhea (especially after eating) or constipation (qi cannot move the stools), lethargy, fussy eating, poor appetite, a pale face, poor muscle tone, a pale tongue and a weak pulse. It stems from one or a combination of: weak constitution, prolonged accumulation disorder (see below), recurrent illness, frequent use of antibiotics, insufficient rest, overstimulation (including TV), poor diet or overeating.

If spleen qi deficiency leads to dampness, as it so often will, there will also be a chronic runny nose. If spleen qi deficiency is combined with or has led to lung qi deficiency, immunity (wei qi) will be low and there will be frequent colds. Unfortunately, these further deplete the child leading to greater qi deficiency and, therefore, lower immunity and so on. Lung and spleen weakness is also the basis for many allergies, skin conditions and asthma.

Accumulation disorder

This disorder manifests in very red cheeks, a tinge of green around the mouth, a bloated belly, poor appetite, abdominal pain that is worse for pressure and eating and better after having a bowel movement, foul-smelling stools, irregular bowel movements (eg. days of constipation, followed by days of loose stools), restlessness, bad breath, vomiting of undigested food, irritability and a stuffy nose. It may also be involved in cases of intestinal parasites. Here, food stagnation – typically from overeating, the overconsumption of hard to digest foods or eating when overexcited – has led to qi stagnation resulting in distension, pain and uneven emotions. The internal blockage generates heat and this is reflected in the ruddy cheeks and explosive nature. This is an incredibly common pattern in young children and because of the interconnection of the digestive and respiratory systems, may also be at the root of some cough and asthma cases.

Lingering pathogens

These are also frequently seen in small children, occurring when infectious diseases are not adequately resolved and the child is left with a condition of chronic phlegm in their system resulting in persistent phlegm, tiredness, character changes, swollen glands and mild symptoms from the original disease (eg sore throat, earache) that become more pronounced when the child is tired.

“The lingering pathogenic factor can be likened to rocks on the sea bed. When the tide of energy is low, the rocks appear.” (1 p47)

This pattern typically results where the child has been unable to adequately rest until they are fully recovered and may also happen after the use of antibiotics (which clear heat but not dampness/ phlegm and may weaken the digestive system, thus generating more damp and phlegm). If left untreated, the pathogen may extend throughout the individual’s life and in to old age. Common recurrent conditions that may be attributed to a lingering pathogenic factor include chronic tonsillitis, ear infections, urinary tract infections and cough (1,2,3).

Other factors in common childhood diseases

Constitutional weakness (kidney deficiency, in TCM) can lead to slow physical and mental development, timidity and conditions such as early-onset asthma and early-onset vision problems (4).
Invasion of external pathogenic factors (colds, flues, infectious diseases): wind, cold, dryness, heat, summer heat, dampness
Lack of exercise
Emotional factors including an emotionally-strained home environment

Signs and symptoms

Some common conditions seen in young children:

Cough
Swollen glands
Fevers
Earaches
Allergies
Vomiting
Diarrhoea
Constipation
Indigestion
Conjunctivitis
Eczema
Asthma
Insomnia
Irritability

Herbal solutions

Because of their stature and dynamic natures, children respond well to very small doses of Chinese herbal medicines. These are typically given in formulas rather than as individual herbs and in decoction form where formulas are composed and modified to meet the needs of the child and its individual constitution. The dosage for children must be lowered and this may be done by either using the same amount of water to cook the herbs and smaller amounts of each herb or by using the standard adult doses and cooking the decoction as usual but administering very small quantities of the tea via a dropper (2). It is not advised that parents prescribe TCM herbs or formulas for their children. Always seek out a qualified TCM practitioner.

Some common TCM herbs and formulas used in the treatment of children:

Herbs that benefit the digestive system

Hawthorn berries (Crataegus spp. fruc.)

shan zha (hawthorn fruit) is the primary TCM herb for dispersing food stagnation. It guides out the food accumulation to relieve bloating, pain and gas and can stimulate the appetite.

chen pi (citrus peel) regulates qi flow, dries damp and cuts phlegm to ‘rectify the centre’ (digestion) alleviating abdominal distension, belching, bloating, hiccups, nausea, vomiting, poor appetite and diarrhea. It is also used for cough with copious sputum.

fu ling (poria) is a leading herb for draining dampness and found in most formulas for this purpose. It treats diarrhoea from excess or deficiency, promotes urination, strengthens the spleen, harmonises the stomach, transforms phlegm and calms the shen (mind/ spirit).

ban xia (pinellia) is likewise indispensible in many TCM formulas for children, but in particular for those treating phlegm.This may be phlegm gumming up the digestion and leading to nausea and vomiting or for cough with copious sputum. Ban xia must always be prepared to remove its toxicity.

gan jiang (dried ginger) warms the digestion in cases of cold and deficiency leading to abdominal pain, diarrhea or vomiting, stimulates appetite, transforms phlegm and also prevents overcooling from other herbs and is a common addition to many formulas.

xiao hui xiang (fennel) also warms the interior and harmonises the digestion but is very good in cases of pain from cold. May also be dry-fried then wrapped in cloth and applied as a compress to the abdomen for cases of pain and cold sensations (5).

bao he wan (Preserve Harmony Pill) is an eight-herb formula including shan zha, chen pi, fu ling and ban xia and a very popular formulation for accumulation disorder, abdominal distension, pain that is better after a bowel movement, belching, nausea, vomiting and poor appetite due to food stagnation.

qi wei bai zhu san (Seven Flavours Atractylodes Powder) is an expansion of another popular paediatric formula – the classic qi tonic formulation, si jun zi tang (Four Gentleman Decoction), made up of ren shen (ginseng), bai zhu (atractylodes), fu lingand gan cao (liquorice). This variation includes the additions ge gen (pueraria), mu xiang (saussurea) and huo xiang (patchouli). Ge gen reinforces the action of stopping diarrhoea, mu xiang alleviates abdominal pain and strengthens the spleen and huo xiang transforms dampness, relieving damp obstruction of the middle perpetuating digestive deficiency. Used for spleen qi deficiency causing chronic diarrhoea, vomiting, loose stools, undigested food in stools, fatigue, weakness, poor appetite, cold limbs and a pale tongue.

Herbs that benefit the respiratory system

jin yin hua (honeysuckle) clears wind and heat from early warm febrile disease, treats red and sore eyes and throats and along with several other heat-clearing herbs such as lian qiao (forsythia) was found to kill the streptococcus bacteria of strep throat in laboratory tests (2). These are the leading herbs in the classic formula yin qiao san (Honeysuckle and Forsythia powder), the go-to formula for the early stages of ‘hot’ colds and flues where fever and sore throat are the predominant symptoms.

For wind-heat common colds with fever where cough predominates, sang ju yin (Mulberry leaf and Chrysanthemum decoction) is prescribed to clear heat, open the lungs and stop cough.

Chrysanthemum (Chrysanthemum x morifolium)

bo he (mint) and ju hua (chrysanthemum flower) are two more common, though milder, cooling herbs for releasing exterior wind-heat and are found in many cold and flu formulas including yin qiao san (bo he) and sang ju yin (both). A poultice of steeped and pressed ju hua may be placed on the eyes to benefit irritation and inflammation from conjunctivitis and bo he tea is a great, palatable home remedy at the onset mild ‘hot’ colds.

xing ren (apricot seed), also found in sang ju yin, is a leading herb for stopping cough and wheezing from either hot or cold conditions and especially dry coughs and is also excellent for constipation. This herb is slightly toxic and must be prepared appropriately to remove toxicity.

xin yi hua (magnolia flower) is pungent and warm, releases the exterior, unblocks nasal passages and is used to treat sinusitis, nasal discharge and sinus headaches.

yu ping feng san (Jade Windscreen Powder) is a powerful formula for building immunity and often used as a preventative treatment for colds and flues, allergies and allergic asthma.

Herbs that benefit the nervous system

suan zao ren (jujube seeds) is a popular sedative herb that alleviates irritability, insomnia and anxiety. The tonic properties of suan zao ren lend it to safe use in children but as it can moisten the bowels it will often be dry-fried (chao suan zao ren) to protect against this action and should never be used if there are loose stools. It is the primary herb in the classic formula, suan zao ren tang (Sour Jujube Decoction), used widely in TCM to calm and treat insomnia.

yuan zhi (polygala) ‘quiets the spirit’ by nourishing the heart and clearing phlegm that is disturbing the mind. It can also help to stop cough with copious sputum.

he huan hua (Persian silk tree flower) is also used to calm the spirit, especially in cases of qi stagnation where stomach qi has been affected causing poor appetite.

gou teng (gambir), tian ma (gastrodia) are often used together to counter-agitation and tension by subduing ‘internal wind’ and curbing ascendant energy (common in young children) to anchor and ground a child’s spirit.

Holistic solutions

Diet

Avoid excess cold, raw greasy, fatty, sweet (including juices), bananas, soy, wheat and dairy foods, bananas, particularly in cases of loose stools and or a runny nose.

Japanese shonishin acupuncture

Opt for warm, easily digested foods, especially in cases of spleen qi deficiency where a clear, bland diet is encouraged and culinary herbs such as fennel (xiao hui xiang), cardamon (sha ren), ginger (gan jiang) and cinnamon (gui zhi) may be added to food. (2)

Paediatric massage

Gentle circular abdominal massage clockwise, following the direction of the large intestine, is beneficial for stagnation (food stagnation and constipation) and anti-clockwise benefits diarrhoea.

In cases of fever, massage repeatedly, but gently, down the centre of the spine.

Acupressure, applying pressure to acupuncture points in place of needles, can be a very effective form of therapy for young children.

Acupuncture

Japanese shonishin acupuncture uses a variety of tools apart from needles and very gentle techniques to stimulate acupuncture points and is particularly suitable to young children who respond well to minimal intervention.

Laser acupuncture is another gentle, non-invasive alternative to traditional acupuncture that is widely used for young children.

Other acupuncture practices for young children, of which there are many, include moxibustion over the navel, sometimes over a slice of ginger, to move stagnation and warm the digestion and gua sha (spooning/ rubbing) along the shoulders and back of the neck to reduce fever.

References

Barlow T, Scott J. Acupuncture in the Treatment of Children. 3^rd ed. Seattle/ Hove: Eastland Press Inc./ Chinese Medicine Publications; 1999.
Flaws B. Keeping Your Child Healthy with Chinese Medicine. Boulder: Blue Poppy Press; 1996.
Scott J. Natrural Medicine for Children. London: Gaia Books; 1990.
Maciocia G. Diagnosis in Chinese Medicine: a Comprehensive Guide. Edinburgh: Elsevier Limited; 2004.
Bensky D, Gamble A. Chinese Herbal Medicine: Materia Medica. 2nd ed. Washington: Eastland Press; 1993.

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Children’s immunity

Jessika Thiele — Thu, 01 Sep 2022 19:10:23 +0000

Children and babies are prone to experience frequent colds and infections. We explore children’s immunity and how to strengthen it naturally.

Understanding children’s immunity

The body is uniquely able to protect and heal itself from injury and disease, and to maintain a state of internal harmony, due to a series of intricate mechanisms that make up the immune system. The immune system is a kind of surveillance system which checks for ‘foreign entities’ entering the body or if they are out of place in the body, and then activates processes to remove them.

Often signs and symptoms of illness are actually evidence of the body carrying out its self-cleansing process to clear whatever pathogens have caused an imbalance in homeostasis (1). The role of medicine is really to assist the efforts of the body to heal itself, rather than to suppress the symptoms of clearing mechanisms.

Children and babies are prone to experience frequent colds, coughs, catarrh, and ear infections. The mucous produced in such cases is doing its job to protect, eliminate, and clear pathogens or irritants that have triggered the immune response. Giving medicines to control symptoms at the first sign of a sniffle or sickness in a child, such as mucous, fever, diarrhoea, or vomiting, can often be more damaging then helpful because it will suppress the body’s natural defences, and potentially send the illness further into the body stimulating a more chronic state. These symptoms are the body’s immune system working to eliminate infections, and so if the body’s defences are working well, it is usually helpful to allow them to do their job without suppressing them. Of course, in some cases, for example if symptoms persist or a fever rises suddenly then medications can be helpful.

Herbs generally work to support the body’s natural defences, rather than to suppress symptoms, and to allow the system to work smoothly so that it returns to a state of health and vitality, functioning as it is designed to. This can be a wonderful source of support to the developing immunity of children, acting to support, nourish and balance the system so that it can function at its best, unaided.

How does children’s immunity work?

The immune system is a complex network consisting of organs, tissues, and cells within the body which in very simple terms will initiate production of necessary immune cells to destroy and eliminate pathogens in order to keep the body healthy. This includes ‘foreign entities’ entering the body from the external environment, and cell debris within the body from dead cells (which are being replaced all the time) that need clearing up.

The main focus of the immune system is on antigens, these are protein-based substances which cause the immune system to produce antibodies against them. A full overview of the immune system and cells involved can be seen in our Immunity article.

Here we will look specifically at children’s immunity: the important thing to understand about this is that children’s immunity is still developing, leaving them more prone than adults to most microbial infections, and as babies and young infants particularly prone to experiencing more severe symptoms (2).

The innate immune system is the first line of defence, which deals with parasites, allergic reactions, bacteria, and recycling dead cells. Cells of the innate immune system already present in new-born babies include monocytes, macrophages, dendritic cells, and neutrophils, but monocytes and macrophages at this stage are immature, and have a lower cytokine response than in adults (cytokines are proteins responsible for control and growth of other immune cells). After birth, the number of neutrophils stabilizes but they have only weak activity towards bacteria. Due to the somewhat muted innate immune system in new-borns, this results higher than in the adults, susceptibility to bacterial and viral infection. The innate immune system is also responsible for activating adaptive immune responses.

Adaptive (or specific) immunity involves immune cells called lymphocytes, made up of B cells and T cells which are responsible for the majority of antibody formation, and Natural Killer (NK) cells which kill damaged or infected cells and call in other helper cells to clear up and prevent infection. B cells and T cells are present in babies and developing children but are different to those in the mature immune system. The thymus gland is involved in the production and storage of T cells, to assist cells infected by bacteria, fungi, and viruses and those involved in adaptive immunity which is developing in children. Therefore the thymus gland is particularly important in the establishment of children’s immunity (1).

The spleen, liver, tonsils, adenoids, and intestinal wall contain lymphoid tissue, which is involved in the production of lymphocytes. In fact, the gut wall contains around 70% of the lymph cells found in the body and are responsible for the important job of responding to all antigens that enter the body through food entering the digestive tract (1).

So, we can see that the immune system itself is complex, and childhood is an important time as the immune system develops, placing emphasis on ensuring that children receive the best foundation for the immune system to develop in a healthy way. This can actually include exposure to a variety of bacteria and viruses during childhood through contact with other people and the surrounding environment so that the body can develop a natural immunity against them should they be encountered again. This is alongside providing sufficient nutrition through a balanced diet. By the age of 7 -8 years, the immune system tends to mature.

Understanding the root of children’s immunity

Children’s immunity is constantly encountering new pathogens and learning how to process or deal with them, leaving children prone to experiencing frequent colds, stomach upsets, or other mild acute (short-term) illnesses which are easily passed around with close contact between children in nurseries and school environments. An undeveloped immune system leaves children more prone to infections than adults and up to 30% of viral respiratory infections in children develop into bacterial complications, which can call for antibiotic treatment (3). Many bacterial infections are becoming resistant to antibiotics, and antibiotics have their own impact on the immune system disrupting the natural microbiota which is important for healthy immunity. Due to antibiotic resistance, there have been campaigns over recent years for doctors to reduce the use of antibiotics, especially in children, but despite these efforts in the UK they are still being prescribed in a high number of cases (67 – 90%) for common childhood ailments of respiratory tract infections (3).

If acute illnesses in children frequently leads to infections or become long-lasting, requiring antibiotic treatment, this is an opportunity to explore what is behind this susceptibility to ill-health, and why the immune system is struggling to maintain a healthy state of balance, and ‘bounce back’ as it is naturally designed to. For this we can look at other factors which can be altered to better support immune health, and herbs are one part of this which can provide much needed support in this new area of antibiotic resistance, where prevention of infection through deeper immune system support can play a huge role.

There are many factors which can influence immune health in children, such as genetic predisposition, environment and lifestyle which includes emotional stress, diet, exercise, quality of sleep and time spent in nature. All of these will contribute to how well a child’s immune system is able to sustain everyday encounters with pathogens and keep the body healthy. This also means that if a child is experiencing frequent bouts of ill-health, in many cases there are many simple changes that can be made which will help support them in experiencing better health.

There has been a rise in issues with children’s immunity in the last few decades, with atopic conditions (allergies) such as allergic rhinitis, asthma, and atopic dermatitis (eczema) becoming common. There is increasing evidence indicating potential links between the gut microbiome and the development of allergies. It is no surprise then that many environmental factors which are linked with the development of allergies, such as antibiotic use, caesarean delivery, and dietary habits also largely effect the gut microbiome (4).

The microflora in early life is highly unstable and undergoes dynamic changes during the first few years, converging towards a more stabilized adult microbiota by co-evolving with the host by the age of 3–4 years. Microbiota studies have underlined the role of dysbiosis (imbalances in the gut microflora) in developing several metabolic disorders like obesity, diabetes and immune-related disorders like asthma, to name a few (5). This shows the important role the gut microbiome plays in the root of immune health in children, and also for their future health.

Alongside this, other factors which affect immunity are diet (in terms of nutrients and variety of whole foods), ability to absorb nutrients (again coming back to gut health), and stress, which can impact on immune function. All of these can be explored when considering the root of how well children’s immunity is functioning.

Signs and symptoms

These are some common health conditions in children which affect their immunity:

Coughs and colds
Ear infections (otitis media)
Sinusitis
Allergies (rhinitis, asthma, eczema)
Conjunctivitis
Gastrointestinal upsets (vomiting / diarrhoea)

Herbal solutions

The aim with herbal support of children’s immunity is very much about regulating and restoring healthy, balanced immune function, so that children are strong and resilient long term. There are many herbs which can provide various types of support to children’s immunity, some of which will be helpful to have in the cupboard for acute infections such as coughs and colds. However, if you are looking at more complex or ongoing immune issues in children such as recurrent infections or allergies, seeking the help of a herbalist is advisable. You can find herbalists on our Resources page.

Liquorice (Glycyrrhiza glabra)

This provides an outline of which herbs help to support different aspects of immune function in children:

Herbs which help to enhance the body’s antibody response to antigens: Echinacea*, golden seal, ginseng
Herbs which increase natural killer (NK) cells: Liquorice, garlic, ginseng, mistletoe, Ganoderma (reishi), shitake
Herbs which regulate T cell response (which can stop infections and inflammation from persisting): Garlic, ginseng, astragalus, liquorice
Herbs which help boost specific B cell derived antibodies: Echincaea* and golden seal increase IgG which can speed up resolution of infections in early stages. Liquorice and schisandra increase supply of antibody IgA which is found in the respiratory and upper digestive tract.
Herbs help with B cells involved in tackling recurrent infections: Liquorice, ginseng, ashwagandha, astragalus
Herbs that can help to modulate IgE-mediated allergic reactions: Echinacea, garlic, golden seal, feverfew, turmeric, chamomile

*Echinacea is in the Asteracea plant family, and occasionally people exhibit allergic reactions to plants in this family (including daisies and chamomile). If a child has a known allergy to these plant then it is best to avoid giving them echinacea.

Specific herbs particularly helpful for children’s ailments and how they are help in supporting children’s immunity

Liquorice

Liquorice is an excellent herb for children because as well as all the benefits for immunity its sweet taste increases the likelihood of compliance in taking it. It works on regulating immune responses so will help to restore healthy immune function and has antiviral properties. It is also helpful for reducing inflammation partly because of its restorative effects on immune function, but also because of its demulcent properties. This makes it soothing and healing for mucous membranes which can help in the digestive tract improving overall gut health, and also in the respiratory system with coughs. Liquorice is excellent in the case of allergies and topically for symptomatic relief of atopic dermatitis.

Because it is beneficial for so many aspects of immunity, Liquorice can be added to most herbal formulations for children to add a sweet taste and increase the likelihood of children taking them.

Liquorice is best avoided in cases of severe diarrhoea because it can have a slightly laxative effect.

Echinacea (Echinacea angustifolia)

Echinacea

Echinacea helps to modulate the immune system (it boosts it when low, and reduces it when overactive). It can enhance immune function, works on lymph tissue throughout the body, and works to limit acute and chronic infections furthermore preventing their onset (6). It is indicated in respiratory tract infections, skins conditions, and gastrointestinal conditions, all of which are common ailments in children.

A recent study of over 150 healthy children between 4 – 12 years old were allocated to a study and control group over a 4 months period given tablets delivering 400 mg of Echinacea purpurea extract 3 times daily, at a preventative daily dose of 1200mg (50% of an adult preventative dose). A control group were given tablets containing 50mg of vitamin C, three times daily a daily dose of 150mg. The results of the study reported that use of Echinacea, compared to the control of vitamin C resulted in significant prevention of cold days and respiratory tract infections by up to 32.5%. This includes specific prevention of enveloped virus infections, including respiratory syncytial virus and in particular a marked reduction of influenza virus infections. There was a reduction in respiratory tract infection complications by 65% and lastly, antibiotic prescriptions were reduced by up to 76.3% for 103 children taking Echinacea for 4 months (3).

The safety of Echinacea was very good with very low numbers of adverse events thought possibly related to study medication. This study demonstrates how beneficial herbs such as echinacea (based on the specific formulation provided in the study) can be in supporting the immunity of children and preventing common complications which often lead to antibiotic use.

In 2012 a warning was issued by the MHRA that as a precautionary measure the remedy echinacea should not be given to children under 12 years old, due to a small risk of a severe allergic reaction which outweighed any benefits (7). However, since this time there has been research demonstrating the significant benefits of echinacea for children in reducing RTI’s and subsequent antibiotic use with minimal allergic reactions within the study group (3). This was based on a specific extract of echinacea, but suggests that unless there is a specific known allergy to this plant family then echinacea can have many benefits to children’s immunity.

Elderberries

Elderberries are immune enhancing andincrease antibody response to infection. Traditionally elderberry has been used as a flu remedy for centuries and is also high in vitamin c (1). Elderberry syrup is often a popular option for children because it is palatable and provides many benefits for immune support. Elderberries must be prepared properly as when eaten raw they can cause nausea and diarrhoea.

Holistic solutions

The best approach for supporting immunity in children is a combination of lifestyle, stress-management, exercise, diet, and the use of plant-based medicines (8).

Diet

Ensuring that children eat a balanced diet can have a big impact not only directly on their nutrition levels and the subsequent benefits to immunity and health of receiving adequate nutrition, but also because of the influence diet has on the gut microbiome, and its role in immune function. This includes plenty of vegetables and fruits, and avoiding where possible junk food and sugar. Sufficient proteins are also necessary for the immune system to function properly (1), this may include the intake of eggs, fish, meat, and soya beans which provide complete proteins easily utilised by the body. Enriching a child’s diet with herbs and herbal teas is a simple way to increase the diversity of healthy nutrients they ingest and promote good health.

Nature biodiversity

There is no doubt that spending time in nature is beneficial for health, in part because of the stress-reducing effect it has which can in turn improve immunity, and children are no exception to this. However, there are also even more profound benefits of spending time in nature for the health of children’s immunity.

Observational studies suggest that immune-mediated diseases are more frequent in populations adopting modern urban lifestyles than in populations with a pre-industrial lifestyle (9). One proposal for this is that children living in urban areas receive less exposure to natural environments (such as forests) where they will encounter environmental biodiversity, which is thought to influence the microbiota of the skin and gut.

A study of children in nursery schools covered the concrete yards with forest floor (sod), trees and other forest materials the children could play on and touch. They found that there was high diversity of skin bacteria in the intervention group exposed to more biodiversity, concluding that exposure to diverse environmental microbiota was associated with changes in skin and gut microbiota of children, which was also found to be related to changes in immunes cell levels, specifically cytokine and T-regulatory cells. The study results indicate that exposure to environmental microbial diversity can modulate function of the immune system in children through changes in their microbiome, which suggests that the relatively simple measure of taking children to the forest or letting them play in the mud has the potential to improve their immune function and health (9).

Sleep

Sleep is important for overall health and therefore immunity. Younger children need between 12 – 16 hours of sleep and adolescents 8 – 10 hours. A regular bedtime routine free of screens in at least the 1 – 2hours before bed is helpful for ensuring good sleep (10).

Activity

For health, it is recommended that children are active for one hour per day, which might be playing in the park, or going for a walk (10).

References

M, Ghobrial RM, Kuchar E, Lewicki S, Kubiak JZ. Development of child immunity in the context of COVID-19 pandemic. Clin Immunol. 2020;217:108510. doi:10.1016/j.clim.2020.108510
Ogal, M., Johnston, S.L., Klein, P. et al. Echinacea reduces antibiotic usage in children through respiratory tract infection prevention: a randomized, blinded, controlled clinical trial. Eur J Med Res 26, 33 (2021). https://doi.org/10.1186/s40001-021-00499-6
F, Paparo L, Nocerino R. et al. Specific gut microbiome signatures and the associated pro-inflamatory functions are linked to pediatric allergy and acquisition of immune tolerance. Nat Commun, 12:5958;2021. https://doi.org/10.1038/s41467-021-26266-z
S.V., Patangia, D.V., Patil, R.H. et al. Factors influencing the gut microbiome in children: from infancy to childhood. J Biosci 44, 49 (2019). https://doi.org/10.1007/s12038-019-9860-z
Bone, K, The Ultimate Herbal Compendium. Warwick, Queensland: Phytotherapy Press; 2007.
Echinacea remedy not for children under 12, says MHRA. BBC News website. https://www.bbc.com/news/health-19318309. Accessed 24 August 2022.
Pizzorno J, Murray M, Joiner-Bey H, The Clinician’s Handbook of Natural Medicine. 2^nd ed. St Loius, Missouri: Churchill Livingstone Elsevier; 2008.
Roslund MI, Puhakka R, Gronroos M, Nurminen N, Oikarinen S, Gazali AM, et al. Biodiversity intervention enhances immune regulation and health-associated commensal microbiota among daycare children. Science Advances. 2020;6:(42). DOI: 10.1126/sciadv.aba2578.
McCarthy C. Child and Teen Health, Boosting your child’s immune system. Harvard Health Publishing Harvard Medical School. 2021. https://www.health.harvard.edu/blog/boosting-your-childs-immune-system-202110122614. Accessed 24 August, 2022.

The post Children’s immunity appeared first on Herbal Reality.

Elderly health

Jessika Thiele — Wed, 24 Aug 2022 18:52:10 +0000

Ageing is a natural process. The changes to our bodies however do not tend to be linear or consistent. We explore the root of elderly health.

Understanding elderly health

Ageing is a natural process, generally referring to the accumulation of molecular and cellular damage over time, and subsequent increased risk of age-related disease. These changes however do not tend to be linear or consistent and are only loosely associated with a person’s actual age (1). This suggests that as we enter the elderly years, it does not necessarily need to mean a complete decline in health, if we are aware of how to best support physical, mental, and emotional health, and in how to adapt to the physiological changes which naturally occur during these later years of life.

The elderly population is increasing as people are living longer than ever, not only in high-income countries, but now also in low and middle-income countries life expectancy is increasing (1). Although modern medicine typically focuses on treating disease and prolonging life, the real importance for elderly health is above maintaining longevity in years, to prioritise delaying the onset of many chronic health conditions (ageing better) and sustaining quality of life for as long as possible, which includes activity, independence (not needing to be cared for), and health. This is where herbalism and a holistic approach can come into its own, providing a natural yet powerful source of support to all aspects of physical, mental, and emotional health during elderly years.

How does elderly health work?

With age comes natural changes to our physiology and how we function, the body’s adaptive capacity to maintain homeostasis (a healthy state of balance) when under stress decreases. This impact on homeostasis can lead to a decline in physical, emotional, and mental health (2).

Whilst there are some variations in older people’s health based on genetics, most are actually due to people’s physical and social environments, which have effects on how they age. Maintaining healthy behaviours throughout life, in particular eating a balanced diet and engaging in regular physical activity contributes to a reduced risk of non-communicable diseases, improves physical and mental capacity, and delays care dependency (1).

This suggests that elderly health can be greatly affected by the lifestyle choices we make not just in elderly years, but throughout our lifetime, which is promising as there is a lot that can be done in terms of prevention to maintain health during elderly years.

Understanding the root of elderly health

The ageing process varies greatly in terms of how it impacts on the health and daily living of each individual. However, there are some common themes at the root of the physiological changes which occur with age and contribute to the general landscape of elderly health and what can arise during this season of life.

Characteristics of the ageing body

Wear and tear

Wear and tear accumulates in the body with age, as cellular repair and replacement slows down, circulation is impaired and levels of anti-oxidants in the cells decreases. Over many years, this increase in wear and tear can lead to an increase in allostatic load (maladaptive processes in the body) (3).

Anabolic and catabolic activity

Anabolic and catabolic activity in the body changes, which can reflect how we age, as there seems to be a shift from anabolic (building up) metabolism which is more active in youth, to increasing levels of catabolic (tearing down) activity. This can lead to a loss of muscle mass as we age, and it is often seen with a relative increase in body fat.

Inflammation

Inflammatory levels seem to increase as we age, this includes the potential for age-related inflammatory diseases such as heart disease, Alzheimer’s, diabetes, arthritis, atherosclerosis, and cancer, and circulation slows down.

Oxidative stress

Oxidative Stress refers to the stress put on the body by an increase in free-radical production. Free radicals are compounds produced through normal metabolism, and which under normal circumstances (when the body is in a state of homeostasis), are fairly easy to control. Stress and some disease states can increase the presence of free radicals, causing oxidative stress and damage at a cellular level. Because with age the body is less well able to adapt to stress and maintain homeostasis, it becomes more prone to oxidative stress, and therefore to the development of age-related health conditions.

However, it is now thought that the process of cellular ageing caused by oxidative stress can be slowed down and in some cases even mildly reversed, with the help of antioxidant support, which is again where herbalism can come into its own, with herbs which provide antioxidant support, whilst also helping to increase the body’s resilience to stress through their adaptogenic action (2).

Low gastric acid

Gastric secretion declines with age, many people aged 65 years or older have abnormally low gastric acid, which can lead to poor nutrient absorption, and abnormal bowel flora, and also being more susceptible to infections (4).

Signs and symptoms

These are the main signs of ageing and issues which may arise as a part of elderly health out of balance (5).

Pain and inflammation in joints and muscles
Hair-loss, or greying hair, less elasticity in the skin, more wrinkles
Loss of muscle strength, flexibility, and reduced endurance
Changes in co-ordination, stability, and balance
Changes in cognitive abilities such as memory recall and multi-tasking
Changes in eyesight which may be linked to age-related eye conditions macular degeneration, or cataracts
Poor circulation
High blood pressure, and other circulatory system conditions such as sudden heart attacks / strokes

Any rapid changes or seemingly premature signs of ageing can be checked with a health professional.

Herbal solutions

There are many ways in which herbalism can support elderly health, particularly supporting the areas which are more prone to degenerate in elderly health. If you have a health condition or take any prescribed medication, it is best to consult a qualified herbalist before seeking herbal support alone.

Adaptogenic herbs

Adaptogen is a term given to herbs which help the body to adapt to stress, restoring normal function and balance. Adaptogens increase the body’s resistance to stressors (whether they are biological, physical, emotional, or environmental), and can slow down the biological ageing process by reducing the impact of physiological ageing factors, primarily oxidation and stress. Adaptogens help reduce wear and tear, balance anabolic and catabolic activity, reduce inflammatory responses, support healthy immunity, and reduce free-radical damage due to their anti-inflammatory and antioxidant compounds. Adaptogens generally help to restore homeostasis in the body and are particularly beneficial in maintaining balance in elderly health.

Herbs often provide many different properties, and here some adaptogens are categorised according to their actions (each herb discussed further below) (2):

Antioxidant adaptogens protect against oxidative damage:

General Anti-aging adaptogens: Asian ginseng, eleutherococcus, goji berries, reishi, rhodiola
Anti-inflammatory Adaptogens: Ashwagandha, Asian ginseng, eleutherococcus, tulsi, liquorice, reishi, rhodiola, schisandra
Adaptogens with anabolic activity: Ashwagandha, Asian ginseng, eleutherococcus, schisandra

You can also read more about some of these adaptogenic herbs from an Ayurvedic and Chinese medicine perspective.

Panax ginseng root (ren shen)

Panax ginseng

Panax ginseng is supportive for many health conditions which are often age-related, is given in traditional Chinese medicine to prolong life, and in Western herbal medicine as a tonic for the elderly (4). It modulates the immune system, regulates the stress response via the HPA axis, has been shown in studies to reduce blood glucose in diabetes patients (6), improve blood lipid profile (7), enhances circulation, and is prevent atherosclerosis due to its antioxidant effect (2). It is given by some herbalists in cases of poor memory, and to delay the progression of Alzheimer’s.

Ashwagandha

Ashwagandha is a tonic adaptogen, which is traditionally given to build strength in the elderly and is considered in Ayurveda to stimulate the mind and prolong life. It helps to regulate the adrenal glands and immune function.

Astragalus

Astragalus is an adaptogen which enhances immune function and prevent infections. It is also given to help improve cardiac blood flow, and in cases of angina and mild congestive heart failure. It is a tonic for qi which in Chinese medicine is our innate life force.

Siberian ginseng

Siberian ginseng is particularly beneficial in supporting an ageing immune system and is generally gentler than panax ginseng.It has been used traditionally to support vitality, libido, memory and longevity. It has been shown to reduce cholesterol, and support function of the heart and cardiovascular system (2).

Tulsi

Tulsi is adaptogenic, antioxidant, neuroprotective, and modulates the immune system. Herbalists give it to enhance cerebral circulation and help memory. Studies have shown it to reduce blood sugar levels in diabetes patients (2).

Liquorice

Liquorice is an adaptogen which supports the nervous system and adrenal glands, helping to modify the body’s stress response.

Reishi

Reishi has been called the ‘mushroom of immortality’ because of its use over the centuries as an invigorating tonic to promote longevity and vitality. It is an adaptogen, has anti-inflammatory and anti-oxidant properties, acts as a heart tonic, modulates the immune responses and the nervous system.

Rhodiola

Rhodiola is an antioxidant adaptogen which benefits the nervous system, enhances alertness and improves memory. It is cardioprotective and stimulates immune function.

Schisandra

Schisandra is an adaptogen which helps to prevent immune system depletion induced by stress, and has a normalising effect on blood pressure.

Bilberry (Vaccinium myrtillus)

Antioxidants

Antioxidant herbs reduce oxidation by binding with and neutralizing free radicals, protecting key cellular components and reducing allostatic load. Health depends on this fine balance between oxidative stress and antioxidant defences, whereby if antioxidant defences are strong, a longer life and less disease is possible. Many herbs offer a wonderful source of anti-oxidant defence which can support elderly health (2).

Bilberry

Bilberry is a powerful antioxidant, anti-inflammatory, and vasoprotective berry. It is particularly helpful in providing support for eye conditions associated with ageing such as glaucoma and macular degeneration, as well as retinopathy associated with diabetes and high blood pressure (8).

Garlic

Garlic is an antioxidant which scavenges free radicals and has been shown to have an anti-ageing activity on human cells (9). It modulates immune activity and helps protect against atherosclerosis. It also prevents platelet aggregation, which is often involved in cardiovascular events and so supports cardiovascular health. It also has a lowering effect on blood pressure, and is good for the gut microbiome.

Ginkgo

Ginkgo biloba is a wonderful antioxidant herb which provides great support in elderly health. It is a circulatory stimulant increasing blood flow, oxygenation and nutrition of tissues, and prevents damage by free radicals (so is highly antioxidant). It enhances memory and cognitive function, especially in the elderly (4).

Hawthorn

Hawthorn is a wonderful herb for elderly health, as an antioxidant, cardioprotective and tonic. It helps to lower blood pressure, encourage peripheral vasodilation, and is an all-rounder for providing support and preventative for age-related health complaints (8).

Rosemary

Rosemary is an antioxidant and circulatory stimulant which helps with memory, concentration, and mental performance. It is also preventative for cardiovascular disease, and slows the ageing process (8).

Please note: If there are any serious underlying health conditions, or if one is taking pharmaceuticals it is important to check for interactions. It is best to consult a qualified clinical herbalist or doctor for this.

Holistic solutions

There is a lot that can be done in terms of lifestyle choices to help maintain health, before we reach elderly years as preventative measures.

Antioxidant diet

Clearly as oxidative stress contributes to the ageing process and age-related issues an antioxidant and anti-inflammatory diet can be helpful in providing additional support. Plenty of fresh vegetables and fruits in a rainbow of colours is what is advised.

Exercise

Many studies have demonstrated benefits of regular physical exercise such as brisk walking for the cognitive function and the structure of the brain. Regular physical activity in middle-aged individuals is associated with better blood supply to the brain, improved cognitive performance, memory, and brain tissue volume. Whilst greater amounts of weight-gain in middle-age are associated with reduced brain tissue volume (3).

Exercise will also help to maintain muscle mass, strength, balance, mobility, and confidence.

Social relationships, meaning and purpose

A decline in health is often seen in people at significant milestones in life such as retirement from work, moving from independent housing or after bereavement of a spouse or partner.

A pilot study with older adult volunteers who were trained as teaching assistants for younger children in neighbourhood schools encompasses education, physical activity, social engagement, and finding meaning and purpose – all important factors for healthy ageing. The physical and mental health of the elderly volunteers improved, who were elevated risk for cognitive impairment, and gains in their executive function and prefrontal cortical activity were also noted (10).

This kind of holistic programme can serve as a model intervention for dramatically affecting the course of chronic health conditions via allodynamic brain mechanisms (3).

Qigong or Tai Chi

Gentle, meditative exercises that help with body posture, movement and improving vitality. They lower stress levels, improve balance and can help maintain and improve quality of life physically, mentally and emotionally.

References

Deshpande, D., n.d. Jara Chikitsa in Ayurveda. [online] Gamrc.org. Available at: <http://gamrc.org/seminar/art/2/F1.pdf> [Accessed 12 July 2022].
Rao RV. Ayurveda and the science of aging. J Ayurveda Integr Med. 2018 Jul-Sep;9(3):225-232. doi: 10.1016/j.jaim.2017.10.002. Epub 2017 Dec 21. PMID: 29276113; PMCID: PMC6148064.
M. Agrawal et al. Concept of Jara and its correlation to Geriatrics. International JOurnal of Pharmaceutical and Medicinal Research. 2014; 2(6):165-168
Smith, V., 2016. Anatomy and Physiology in Ayurveda Dietekon, Switzerland: EIVS Gmbh
Who.int. n.d. Ageing and health. [online] Available at: <https://www.who.int/news-room/fact-sheets/detail/ageing-and-health> [Accessed 15 July 2022].
McIntyre, A., 2012. The Ayurveda bible. Alresford: Godsfield.
McIntyre, A., 2012. The Ayurveda bible. Alresford: Godsfield.
Upadhyay AK, Kumar K, Kumar A, Mishra HS. Tinospora cordifolia (Willd.) Hook. f. and Thoms. (Guduchi) – validation of the Ayurvedic pharmacology through experimental and clinical studies. Int J Ayurveda Res. 2010 Apr;1(2):112-21. doi: 10.4103/0974-7788.64405. PMID: 20814526; PMCID: PMC2924974
Doshi GM, Une HD, Shanbhag PP. Rasayans and non-rasayans herbs: Future immunodrug – Targets. Pharmacogn Rev. 2013 Jul;7(14):92-6. doi: 10.4103/0973-7847.120506. PMID: 24347916; PMCID: PMC3842000.
. McIntyre, A., 2007. Positive Health Online | Article – Rasayana: The Ayurvedic Path to Rejuvenation. [online] Positivehealth.com. Available at: <http://www.positivehealth.com/article/ayurveda/rasayana-the-ayurvedic-path-to-rejuvenation> [Accessed 14 July 2022].
Smith A.,2009. A Textbook On “Dravyaguna for Westerners” Dietekon, Switzerland: EIVS Gmbh.
Pole, Sebastian. Ayurvedic Herbs: The Principles of Traditional Practice. Churchill Livingstone, 2013. (189-190)911-192, 304-311.13.
Upadhyay AK, Kumar K, Kumar A, Mishra HS. Tinospora cordifolia (Willd.) Hook. f. and Thoms. (Guduchi) – validation of the Ayurvedic pharmacology through experimental and clinical studies. Int J Ayurveda Res. 2010 Apr;1(2):112-21. doi: 10.4103/0974-7788.64405. PMID: 20814526; PMCID: PMC2924974
hMishra, Y., Vijay, N., Krunal, T., Nagaraj, B. and B., S., 2016. Role of Rasayana in Geriatric Care – A Review. Journal of Ayurveda and Integrated Medical Sciences (JAIMS), [online] 1(1). Available at: <https://www.researchgate.net/publication/308955373_Role_of_Rasayana_in_Geriatric_Care_-_A_Review> [Accessed 14 July 2022].
Diagnose-me.com. n.d. Premature/Signs of Aging – Symptoms, Diagnosis and Treatment. [online] Available at: <https://www.diagnose-me.com/symptoms-of/premature-signs-of-aging.php> [Accessed 22 July 2022].

The post Elderly health appeared first on Herbal Reality.

Elderly health: A traditional Chinese medicine perspective

Jessika Thiele — Tue, 19 Jul 2022 15:55:59 +0000

Traditional Chinese medicine has so much to offer our older citizens and the demand for gentle, natural ways to improve elderly health is increasing.

Understanding health conditions affecting the elderly

We live in an ageing society. According to the WHO, by 2050 nearly one quarter of the world’s population will be over the age of 60. Heart disease, stroke and chronic pulmonary disorders are the leading killers of the elderly (1) with cardiovascular diseases the main cause of non-communicable disease in any age-group, causing approximately one third of all deaths globally (2).

The leading causes of disability in the elderly are sensory impairments, back and neck pain, chronic obstructive pulmonary disease (COPD), depressive disorders, falls, diabetes, dementia and osteoarthritis and many of these can be postponed or even avoided depending on how we conduct our lives (2).

From soothing aching joints, calming the nerves and supporting restful sleep to treating stroke and angina either alone or as an adjunct to conventional medicine, at the bedside or in a Chinese hospital, traditional Chinese medicine has so much to offer our older citizens and the demand for gentle, natural ways to do so is only increasing.

How do conditions affecting the elderly work in TCM?

“fu jing zhe, sheng zhi ben ye.“
“A person’s essence is the root of life.” (3)

Historically, afflictions of the elderly have been seen in TCM as a decline in jing, our inherited, constitutional essence stored in the kidneys that provides the substance for development and growth. As the years go by, this essence naturally declines – slower if we lead a healthy, balanced life – and with its waning the signs of ageing emerge. Our kidney yin and yang energies also deplete along the journey, becoming less able to cool, moisten, nourish or warm and activate, respectively. Hair whitens, skin dries and wrinkles, organs lose their nourishment and vitality, circulation slows. The ‘marrow’, produced by the kidneys, weakens and is less able to nourish the bones and brain. Senility, frailty and failing senses emerge and once jing is fully consumed, we pass away. This is, of course, the description of a natural process, but one that TCM has slowed and supported for thousands of years.

However, whether as a result of changed environments, diets and lifestyles – with declining physical activity, circulation slows and the development of phlegm and blood stasis increases – or, perhaps, the new light shed on conditions affecting the elderly by modern research, geriatric disorders, particularly those with the greatest rates of morbidity such as heart disease and stroke, are now largely seen as conditions of excess involving one or a combination of the following pathogenic factors: blood stasis, phlegm and internal wind (4,5). These may have deficiency at the root, but the presenting conditions will be predominantly excessive in nature. As such, the modern clinical application of TCM for the elderly, especially in more severe conditions, has shifted from tonifying deficiency towards eliminating excess.

Understanding the root

The natural process of ageing may be accelerated or complicated by factors such as:

Genetics
A sedentary lifestyle
Smoking
Prolonged chemical/ pollutant exposure
Excessive alcohol consumption
Poor diet
Obesity
Isolation
Poverty
Stress
Injuries
Illness

The following are some of the more common factors impacting health in the elderly from a TCM perspective, with examples of some of their TCM signs and symptoms and associated biomedical conditions. This is a very general overview and there is often an overlap of signs, symptoms and conditions. Likewise, in clinical practice pathological factors are typically combined – for example, internal wind with phlegm is a very common presentation in pathologies affecting the elderly.

Deficient pathologies

yin deficiency

Feeling of heat, dizziness, dry throat, hoarse voice, chronic cough that is worse in the evening and dry/ with difficult to expectorate sputum, sore low back and knees, insomnia (trouble staying asleep), atrophy of the limbs, weakness of the knees, restless legs, poor night vision, dry brittle nails, constipation, scanty dark urine, a tongue without coat, lordosis (swayback), myopia (short-sightedness), cataracts, COPD, with deficient heat: depression, anxiety that is worse in the evening, feeling of heat in the head, nightsweats, psoriasis, excessive ear wax, poor memory, chronic light nosebleeds, chronic sore throat, mouth ulcers, loose teeth, bleeding gums, receding gums, dry lips, streaming eyes, red eyes, hot hands, burning sensation in the soles, a red tongue with a dry yellow coat.

yang deficiency

Tiredness, dizziness, feeling of cold in legs and back, sore low back and knees that are better for rest, abundant clear urination, urination at night, straining to defecate, day-break diarrhea, a pale wet tongue, with excess fluids: severe breathlessness, oedema – especially of the legs and ankles, palpitations, drooling/ excessive saliva, abdominal distension, a pale, swollen tongue.

jing deficiency

Softening of bones, hair loss, poor memory, loose teeth, dizziness, tinnitus, low back ache, kyphosis (rounding of upper back), deafness

Blood deficiency

Dry, cracking nails, dry skin and hair, dizziness, restless legs, insomnia (getting to sleep), constipation, a pale tongue, anaemia

Excess pathologies

Blood stasis

Pain that is fixed and stabbing in nature, chest pain, reddish-purple bridge of the nose, a purple tongue, irregular or taught pulse, macular degeneration, heart disease, angina, arteriosclerosis, cerebrovascular disease, cancer

Phlegm

Dizziness, tics,nodules under the skin, brain fog, numbness, phlegm in the throat, confusion, poor memory, tremor, feeling of oppression of the chest, epigastric pain, stones, nausea, productive cough, shortness of breath , poor appetite and digestion, swollen hands with yellowish thickened nails, a swollen tongue with a sticky coat, cataracts, asthma, reflux, goitre (slow-onset, soft), Alzheimer’s disease, high cholesterol, chronic bronchitis, trigeminal neuralgia, with excess fluids: pale, bluish or pale-yellow and swollen tip of the nose, swollen face, feeling of oppression on the chest especially when lying down, palpitations

Internal wind

Stiff and painful neck, tic, deviation of eye and mouth, unstable gait, tremors, severe dizziness, tinnitus, headache, unilateral numbness of the face, itching, contraction of the upper limbs and fingers, a stiff, deviated, quivering tongue, alopecia, strabismus (squint), nystagmus (quivering eye ball), sudden blindness, Parkinson’s disease, hypertension, stroke, paralysis, vertigo (4,6)

Signs and symptoms

Major causes of death in the elderly:

Heart disease
Stroke
Chronic lung disease

Major causes of disability in the elderly:

Sensory impairments
Back and neck pain
Chronic obstructive pulmonary disorder (COPD)
Depressive disorders
Fall
Diabetes
Dementia

‘Geriatric syndromes’:

Frailty
Functional limitation
Polypharmacy
Malnutrition
Cognitive impairment
Dementia
Depression
Delirium
Vertigo
Falls
Spontaneous bone fractures
Failure to thrive
Neglect and abuse
Urinary incontinence
Pressure ulcers

Herbal solutions

Chinese herbal medicine tends not to use herbs individually but in synergistic formulae. It is important to consult a qualified TCM practitioner, particularly in cases of serious disease, as they must be carefully prescribed and modified to match the individual’s presenting symptoms, environment and constitution. Depending on the condition and conventional medications the patient is taking, it may also be pertinent to refer to or liaise with and work alongside their primary health care practitioner and herb dosage should always be lowered for the elderly.

Rehmannia (Rehmannia glutinosa)

Tonics

Shu di huang (Rehmannia glutinosa)

Prepared Rehmannia nourishes blood, yin and jing to treat conditions such as palpitations, insomnia, loose teeth, incontinence, low back pain, weakness of the legs, dizziness, tinnitus, deafness, poor vision, premature greying of hair and diabetes. Prescribed in most formulas for kidney deficiency, it is the chief herb of the leading formula for kidney yin deficiency, liu wei di huang wan (Six Ingredient Rehmannia Pill).

Ren shen (Panax ginseng)

Ginseng used in TCM for millennia to treat conditions of weakness and promote longevity. Strongly tonifies qi and blood and calms the shen. Research has shown it to be beneficial in cases of depression and anxiety where hyperactivation of the HPA axis is present by reducing CRH, ACTH and cortisol (7). Systematic reviews have found it beneficial for hearing loss, hypertension, diabetes and cancer. Clinical studies show it improves congestive heart failure (CHF) alone or with digoxin and is comparable to digoxin and can benefit dry eyes, obesity, cognitive function, ageing skin, stamina and immune function. In a two-year trial, ren shen stabilised cognitive function in Alzheimer’s disease subjects (8). It also features in the formula bu fei yi shen – alongside huang qi, shu di huang and others – a TCM combination frequently employed for COPD. In cases of yin deficiency, ren shen may be substituted with xi yang shen (American Ginseng) which is cold in nature.

Ling zhi (Ganoderma lucidum)

Reishi is another classic ‘anti-ageing’ aide with benefits for cancer (especially breast and prostate), liver disease, hypertension, insomnia, anxiety and rheumatoid arthritis. Along with its cardiovascular, neurological and immune benefits, it has glycaemic and lipid controlling abilities, and would appear worthy of the translations, ‘mushroom of immortality’ and ‘spirit mushroom’ (9).

Dang gui (Angelica sinensis)

Dong quai is a chief blood tonic and blood invigorator and is also used to moisten the bowels and relieve constipation from dryness. It is an important herb for pain, including rheumatism, injuries and arthritis and is used to treat anaemia, blurred vision, dizziness, numbness in the limbs, palpitations and weakness from blood deficiency. Human research has shown it decreases infarct volume and can improve function in stroke. Further clinical studies showed that alongside huang qi and ren shen it can reduce angina and it was also beneficial for pulmonary hypertension, coronary artery disease, cirrhosis, portal hypertension, stroke, anaemia of chronic disease and cancer (8).

Dang shen (Codonopsis pilosula)

Codonopsis is a leading TCM qi tonic and support for fatigue, weakness, poor digestion, chronic cough and shortness of breath. A 2015 systematic review and meta-analysis of 48 randomised control trials found that dang shen formulae showed promise for the treatment of COPD but further investigation is needed (10).

Suan zao ren (Zizyphus spinosae)

Jujube seeds are a commonly-used yin and blood tonic and sedative that alleviates irritability, insomnia and anxiety with palpitations in cases of yin or blood deficiency. As an astringent, it is beneficial for spontaneous sweating and nightsweats. It has also been shown to reduce blood pressure. (11) The tonic properties of suan zao ren lend it to safe use in the elderly and it is the primary herb in the classic formula, Suan Zao Ren Tang (Sour Jujube Decoction), used widely in TCM to treat insomnia from yin and blood deficiencies.

Goji berry (Lycium barbarum)

gou qi zi (Lycium barbarum)

Goji is another popular blood, yin and, to a lesser extent, yang and jing, tonic used widely to promote longevity and benefit the eyes. Its anti-ageing reputation may be attributed to its antioxidant, immunoregulative, anti-apoptotic properties and ability to reduce DNA damage, thus inhibiting biological aging (12). A systematic review found them beneficial for glycaemic control and, therefore, diabetes. Clinical studies have shown benefits for macular degeneration, dyslipidemia, insomnia, anxiety, cognition, stress, fatigue, immunity and cancer (8).

Huang qi (Astragalus membranaceus)

Astragalus is an important qi tonic often used for debility, poor digestion and low immunity. Systematic reviews have displayed benefits for diabetic nephropathy and immune function. Clinical studies found it benefits congestive heart failure, protects against ischemia (restricted blood flow to part of the body) and reperfusion injury (damage caused to tissue when blood flow is restored), as well as asthma, coronary artery disease, cancer and can improve recovery from hemorrhagic stroke (8).

Xu duan (Dipsacus asper)

Dipsacus tonifies yang and invigorates blood making it ideal for stiffness and pain, particularly of the lower back and knees, from blood stasis caused by weak yang qi, a frequent presentation in the elderly.It is also a common remedy for bone weakness and injured bones (13).

Du zhong (Eucommia ulmoides)

Eucommia tonifies yang, supports yin, strengthens the sinews and bones and is often used for lower back and knee weakness, fatigue and frequent urination. It also lowers blood pressure and stops dizziness from ‘yang rising’ which is common where yin is weak and stress is present.

Mai men dong (Ophiopogon japonica)

Ophiopogon nourishes yin, moistens the lungs and stops cough and is frequently found in TCM formulas for COPD.

Turmeric root (Curcuma longa)

Blood invigorators

Dan shen (Salvia miltiorrhiza)

Dan shen is a blood invigorator that can also calm the spirit and clear heat. It has demonstrated circulatory, cardiovascular, cerebrovascular and neuroprotective benefits. It is primarily used for cardiovascular disorders and liver fibrosis but is increasingly being applied to all blood stasis syndromes, in particular those associated with ageing, autoimmunity, and progressive diseases (13). fu fang dan shen pian (Compound Dan Shen Dripping Pill (CDDP)) – made up of Salvia (dan shen), Notoginseng (san qi) and Borneol (bing pian) – is used widely in Chinese hospitals to treat angina pectoris and was the first TCM formulation to successfully complete Phase II clinical trial under the US Food and Drug Administration (FDA)’s Investigational New Drug (IND) application.

San qi (Panax notoginseng)

Notoginseng is another important blood invigorator found in formulations for cardiovascular disease and stroke prevention. It has analgesic properties and the unique ability to both invigorate blood and arrest bleeding.

Jiang huang (Curcuma longa)

Turmeric is a popular anti-inflammatory and analgesic herb in western herbalism, TCM and Ayurveda. In TCM, it invigorates qi and blood and stops pain, especially in the shoulder, abdomen and chest, and is given for liver congestion, gallstones, hepatitis, arthritis and wounds. Systemic reviews have displayed its ability to help diabetes mellitus, diastolic hypertension, dyslipidemia, anxiety and depression. Clinical studies showed it improved endothelial function and benefitted coronary artery disease, asthma, reflux, rheumatoid arthritis, fatigue, cancer and was hepatoprotective (8).

Phlegm herbs

Ban xia (Pinellia ternate)

Pinellia is the primary TCM herb for resolving phlegm and a popular choice for cough with copious sputum, especially from phlegm-cold in the lungs. It also benefits digestion where this has been impacted.

Shi chang pu (Acorus gramineus)

Acorus ‘opens the orifices’ by transforming phlegm and thus benefits the mind and spirit (shen), treating seizures, deafness, dizziness, forgetfulness and stupor and is often found in formulas that benefit nervous disorders and cognitive function. Preparations of shi chang pu were found to prolong the effects of barbiturates (11).

Wind herbs

Tian ma (Gastrodia elata)

Gastrodia calms wind, descends ascendant qi, hasan analgesic effect and is used for headaches, dizziness, hypertension, stroke with numbness in the extremities and spasms.

Gou teng (Unicaria rynchopylla / sinensis)

Gambir also calms wind but is cool in nature descends yang. It is used for spasms, tremors, seizures, headaches and hypertension.

Ginkgo leaves and fruit (Ginkgo biloba)

Herbs that ‘stabilise and bind’

Ginkgo (Ginkgo biloba)

The ginkgo plant is a well-known herbal aide with many applications for the elderly. Bai guo, the ginkgo nut, benefits the kidneys and lungs in TCM and is traditionally used for wheezing and cough with phlegm, as well as frequent urination and incontinence. Yin guo ye, the ginkgo leaf, is the more popular of the pair, has been extensively researched and systematic reviews have found it benefits vertigo, tinnitus, cardiovascular health, dyslipidemia, diabetes, stroke, mild cognitive impairment and dementias. Clinical studies showed benefits for macular degeneration, glaucoma, claudication (pain while walking), depression and ageing skin (8).

Wu wei zi (Schisandra chinensis)

Schisandra is an important tonic astringent herb that benefits the heart, kidneys and lungs and treats ‘leakages’ in the form of cough, wheeze, night sweats, diarrhea and frequent urination. It is also a calming herb and benefits nervous conditions. A systematic review showed benefits for congestive heart failure and clinical studies displayed its ability to treat diabetes, non-alcoholic fatty liver disease, cognition, stamina, pneumonia and cancer (8).

Herbs for cough and wheeze

Xing ren (Prunus armeniaca)

Apricot seed is an important TCM herb for arresting cough, particularly dry cough, and wheeze and is a primary herb for bronchitis and asthma, both hot and cold in nature. It also moistens the intestines to promote bowel movements, especially useful for the elderly who often suffer from dry intestines. ma zi ren wan (Hemp Seed Pill) in which it is a deputy herb, is a classic formula for this purpose.

Holistic solutions

General principles

Eat a healthy diet
Quit smoking
Maintain a healthy weight
Avoid excessive alcohol consumption
Get regular exercise
Use stress reduction techniques
Study something new
Keep social

Tai chi and qi gong

Tai chi is a hugely popular form of exercise amongst older citizens in China where it is used to encourage circulation, calm the mind, promote strength and balance and has been proven to reduce falls in the elderly (14). Qi gong (‘qi exercises’) is also a common practice for building and preserving energy and strengthening the body and mind.

TCM diet

The elderly, particularly those with yang deficiency or cold, will typically benefit from warm, well-cooked foods due to naturally weakened digestive systems and possible dental issues. Adding warming spices such as fresh ginger can support digestion and may be particularly welcome in the cooler months.

In cases where heat and, or, yin deficiency is present it may be necessary to reduce or avoid warming foods and stimulating substances such as chilli, pepper, garlic, cinnamon and excessive red meat (especially lamb), fried foods, sugar, caffeine and alcohol.

In cases of phlegm avoid damp-forming foods – excessively cold, raw food, greasy, fatty foods, dairy, bananas, peanuts, sugar, flour products, avocados and incorporate foods that cut phlegm such as pear, turnips, radishes and seaweeds.

References

Centre of Ageing Better. The State of Ageing 2022. Published March 2022. Accessed July 2022. https://ageing-better.org.uk/health-state-ageing-2022.
Hu YX et al. Proangiogenesis Effects of Compound Danshen Dripping Pills in Zebrafish. BMC Complement Med Ther. 2022; 112. https://doi.org/10.1186/s12906-022-03589-y
Flaws B. Statements of Fact in Traditional Chinese Medicine. 9^th ed. Boulder: Blue Poppy Press; 2010.
Maciocia G. Chinese Medicine Treatment Principles for Geriatrics. Accessed July 2022. https://giovanni-maciocia.com/geriatrics-in-chinese-medicine/
Dharmananda S. Salvia and the History of Microcirculation Research in China. Published August 2001. Accessed July 2022. http://www.itmonline.org/arts/salvia.htm
Maciocia G. Diagnosis in Chinese Medicine: a Comprehensive Guide. Edinburgh: Elsevier; 2004.
Li C, Huang B, Zhang YW. Chinese Herbal Medicine for the Treatment of Depression: Effects on the Neuroendocrine-Immune Network. Pharmaceuticals (Basel). 2021;14(1):65. Published 2021 Jan 14. doi:10.3390/ph14010065
Bokelmann J. Medicinal Herbs in Primary Care: An Evidence-Guided Reference for Healthcare Providers. Philadelphia: Elsevier; 2022.
Powell M. Medicinal Mushrooms: A Clinical Guide. Eastbourne: Mycology Press; 2010.
Shergis JL et al. Dang Shen [Codonopsis pilosula (Franch.) Nannf] Herbal Formulae for Chronic Obstructive Pulmonary Disease: a Systematic Review and Meta-analysis. Phytother Res. 2015 Feb;29(2):167-86. doi: 10.1002/ptr.5248.
Bensky D, Gamble A. Chinese Herbal Medicine: Materia Medica. 2nd ed. Washington: Eastland Press; 1993.
Gao Y et al. Lycium Barbarum: A Traditional Chinese Herb and A Promising Anti-Aging Agent. Aging Dis. 2017;8(6):778-791. Published 1 Dec 2017. Accessed 1 June 2022. doi:10.14336/AD.2017.0725
Dharmananda S. Degenerative Diseases: Interpretation and Treatment with Chinese Medicine. Published August 2005. Accessed July 2022. http://www.itmonline.org/arts/degenerative.htm
Huang Z et al. Systematic Review and Meta-analysis: Tai Chi for Preventing Falls in Older Adults. BMJ Open 2017;7:e013661. doi: 10.1136/bmjopen-2016-013661

The post Elderly health: A traditional Chinese medicine perspective appeared first on Herbal Reality.

Elderly health: An Ayurvedic perspective

Jessika Thiele — Mon, 18 Jul 2022 19:17:07 +0000

Ayurveda doesn’t view ageing as a disease process but as a natural, inevitable progression where the mind and body can remain healthy. We explore elderly health from an Ayurvedic perspective.

Understanding elderly health

Ayurveda doesn’t view ageing as a disease process but as a natural, inevitable progression where the mind and body can remain healthy (2). As the science of life and longevity, Ayurveda aims to improve quality of life and self-dependency rather than just extend the years of life (1). The aim of Ayurveda is to achieve total overall good health on all levels. Jara Chikitsa or Rasayana Chikitsa is one of the eight specialised branches of Ayurveda and is dedicated to elderly/geriatrics and rejuvenation therapy. This is one of Ayurveda’s key strengths (3).

How does elderly health work in Ayurveda?

Jara, also called Vardhakya (ageing), is defined as which has become old by the act of wearing out (2).

It is our daily choices and actions that are largely responsible for rapid ageing and degeneration of the body and mind, and nobody wants to grow old or suffer from degenerative disease. Modern medicine often can’t offer much apart from managing diseases once they arise. Ayurveda however can help with prevention of diseases and support the process of healthy aging with several lifestyle and dietary measures (1).

In Ayurveda, there are three stages of life known as Vaya. Balavastha up to age 16, Madhyavastha 16-60 and Vriddhavastha or Jirnavastha after 60 which is the elder years (1).

In our elder years the vata dosha dominates so there are more catabolic activities taking place in the body which can lead to many chronic diseases such as osteoarthritis, Alzheimer’s, Parkinson’s, dementia, hypertension and stroke. The sense organs, speech, memory and cognition can also degenerate (1).

Agni (digestive fire) weakens with age leading to diminution of the dhatus (tissues), therefore leading to a decrease in ojas, the prime essence responsible for vitality and immunity (14).

Unhealthy changes in the body and mind occur due to imbalances within the doshas, dhatu (tissues), agni (digestive fire) and malas (metabolic wastes) which are all influenced by lifestyle, diet as well as the rhythms and cycles of nature (1).

Understanding the root of elderly health in Ayurveda

Doshas

According to Ayurveda, there are three primary life forces that are responsible for all physical and psychological functions in the body. These are known as the doshas, vata, pitta and kapha (7).

Vata is closely related to Prana (vital energy) and governs all movement, pitta governs digestion and metabolism, kapha controls anabolism, is the energy of building and lubrication that provides the structure to the physical form (7).

Everyone is born with their unique mix of doshas called prakriti which need to be kept in balance to remain well and healthy. The doshas also dominate times of day, seasons and lifespan. The first 25-30 years of life is a kapha dominant stage as growth takes place. The middle years are pitta dominant then above 60 vata becomes the dominant dosha. For elderly people, it is important to adopt vata pacifying practices (7).

There are also subtle expressions of the doshas.

Prana is our subtle life energy, the breath of life, which controls breath, sensory perceptions and the thought process. Tejas is the subtle fire representing the digestion and transformation of sensory impressions, thoughts, perception and awareness. Ojas is a subtle immunity that represents strength, vitality and robustness (2).

The ancient classical Ayurveda text, Caraka Samhita, states that there are two kinds of Ojas.

The Ojas that live in the heart and head, it is subtle and cannot be seen or known directly. We are born with eight drops of Ojas in the spiritual heart. These can be strong or weak and determines our overall vitality throughout life and are fixed for life.
The Ojas that can be built up or depleted though food, lifestyle, meditation, relate directly to dhatu (tissue) metabolism and kapha dosha. This form of Ojas is not fixed and can be increased though food. These Ojas help us to resist disease, and environmental changes and increase longevity (4).

Agni (digestive fire)

In Ayurveda we are not what we eat, but what we are able to digest and absorb. If agni is weak then food cannot be digested properly resulting in malabsorption and accumulation of ama (toxins). If agni is too strong it can burn the dhatu (tissue) resulting in dhatu degeneration.

Imbalanced agni can result from stress, eating ultra-processed foods or stale foods, from over-eating, eating when not hungry or eating late at night. Food that can’t be digested can ferment in the gut resulting in ama (toxins) (7). Ama can be moved through the body by vitiated vata where it can lodge in a weak dhatu causing degeneration and disease.

The primary agni, Jatharagni, is the digestive fire in the gut which transforms and breaks down food into a nourishing essence called ahara rasa. This is then absorbed by the bloodstream and taken to the liver. In the liver there are five bhuta agni which transform the ahara rasa in to the first dhatu, rasa dhatu. The essence is refined and passed on to the second dhatu which uses it to build itself and then passes an even more refined essence on to the next dhatu. This process is repeated though all seven dhatus with the essence becoming more refined and potent. The last dhatu, shukra dhatu, produces ojas which then moves back through all the dhatus to nourish all the levels of the body (4). If Jatharagni or dhatu-agni is impaired then the dhatus will be low quality so Ojas will also be low.

Malas (wastes)

The body eliminates malas through faeces, urine and sweat. It is important that malas are eliminated daily otherwise toxins can build up contributing to disease and degeneration. (7) Often elderly people do not feel thirsty so dehydration can develop. They might also not be very mobile. Both can contribute towards constipation and retention of toxins. (11)

Signs and symptoms

It is important to pay attention to the changes in the body and mind to determine if pre-mature ageing is occurring. Some of the common signs and symptoms of ailing elderly health are: (15)

Pain and inflammation – joints, muscles, sense organs, internal organs, head, bodily tissues
Loss of hair, decreasing skin elasticity, wrinkles, greying hair
Worsening hearing or eyesight
Poor balance
Decrease in neurofunction
Poor circulation
Cataracts
Diagnosed degenerative conditions or sudden heart attacks/strokes

Herbal solutions

Ayurveda is a customised and individual approach. It is always best to seek advice for a qualified practitioner who can offer correct guidance. Rasayana or rejuvenation therapy means “Those therapies that increase the Rasa of the body.” This means the rasa dhatu as a fluid tissue which nourishes the other tissues in the body, and circulates rasa throughout the body. Rasayana therapies tonify and nourish the whole system. They help build and nourish the body and the herbs are also often pungent and stimulating in order to keep rasa circulating.

Each dhatu gets worn down by the dhatu-agni functioning inside it. Agni’s constant metabolic processes wear out the very dhatu that it helps to build and maintain. Rasayana counteract this natural wear and tear by providing extra nutrients in the form of concentrated herbal medicines. Rasayana increase ojas and are particularly good for the elderly helping to achieve a long and healthy life (7).

Rasayana can protect the body and mind from the ravages of age by their non-specific effect on the immune system. They are high in antioxidants so help to prevent damage from free radicals and they bring about proper nourishment, growth and function of all seven dhatus (10).

For Rasayana to be of the greatest benefit for healing and rejuvenation, agni needs to be optimal, ama (toxins) should be cleansed from the system and the doshas should be balanced (10).

Most Rasayana herbs have adaptogenic properties which help enhance resistance to all types of stress. They contain antioxidants which help prevent damage by free radicals. They also provide proper nourishment to all seven dhatus. Rasayana’s should not be taken if there is high ama (toxins) in the body. Always consult a qualified herbalist or Ayurveda practitioner to determine what herbal medicines are suitable and the correct dosage.

Ashwagandha flowers (Withania somnifera)

Ashwagandha (Withania somnifera)

Ashwagandha is one of the most highly acclaimed rasayana’s (10). Its sweet post digestive taste helping to nourish all seven dhatus, promote ojas and rejuvenate the body. It is excellent for reducing vata and rejuvenating the vata sites of the body, such as bone marrow (11). Ashwagandha increases memory and learning capabilities, strengthens the central nervous system and reduces physical and mental stress and exhaustion, improving elderly health. Ashwagandha is reopened during covalence for weakness, emaciation, for problems of old age such as poor memory, weak eyes and arthritis (7).

Shatavari (Asparagus racemosus)

Shatavari is also an excellent rejuvenator and is one of the main rasayana’s for pitta. It has an affinity for the mind helping to promote memory and mental clarity. It is good for the eyes; it nourishes dry membranes (7). It is adaptogenic, antioxidant, immuno-stimulant and can enhance the level of white blood cells and macrophages. It is used for enhancing resilience to stress, general debility, urinary problems and to help with female hormonal imbalances (10).

Amalaki (Embelica officinalis)

Amalaki has a well-deserved reputation as a powerful rejuvenator herb and is used in many ayurvedic rejuvenative formulas. Amalaki fruit is said to have the highest vitamin C content of all plants so is a very good antioxidant that is beneficial to the immune system. It helps promotes ojas. (11) It’s cleansing and nourishing properties help purify the blood, rebuild tissue after injury or illness and improve eyesight. It helps reduce cholesterol, helps prevent clotting so protects the cardiovascular system. It is well known for relieving debility following illness, stress or old age (7).

Amalaki balances all three doshas. As it has a cooling potency it is especially good for pitta helping to relieve heat and inflammation thought the body (7) in elderly health. It has five of the six tastes, sweet, sour, pungent, bitter, astringent which help to enhance agni (digestive fire) and cleanse the body. It’s sweet post digestive effect makes it nourishing for all dhatu. Amalaki is used in many ayurvedic rasayana formulas (7).

Guduchi (Tinispora cordifolia)

Guduchi is also known as Amrtā or nectar of the Gods indicating its importance in Ayurvedic pharmacopeia (12). It is a rejuvenating tonic that supports the immune system, enhances vitality and supports longevity. Guduchi’s reputation as an ‘elixir of life’ is well earned by how many bodily systems it supports (13).

Guduchi helps to clear ama, strengthen the digestive system and balance gut bacteria. It helps ease joint discomfort, regulates metabolism and blood sugar levels, supports the livers detoxifying work and its adaptogenic properties help to lessen the impact of stressors as well as calm and nourish the nervous system (13).

Guduchi balances all three doshas especially pitta. It has a bitter, astringent taste which helps clear pitta and kapha from the system. It has a hot potency which clears ama helping to detox the liver, kidneys, joints and blood. It’s post digestive effect is sweet and unctuous which helps balance vata and nourish the dhatus (tissues) and fluids of the body (13).

Sweet flag (Acorus calamus)

Vacha (Acorus calamus)

Vacha is one of the most utilized brain and nerve tonics in Ayurveda due to its ability to rejuvenate the mind and the nervous system (7). Vacha enhances mental clarity, concentration, speech and the ability to perceive (Buddhi). With its bitter, pungent and astringent taste it clears ama from the srotas (channels) especially the subtle congestion of mental, emotional or energetic forms of toxins. (11)

Vacha is considered the best herb to use for nasya. Care should be taken in case of high pitta as it can increase pitta. This is an excellent method of rejuvenating the sinus and brain as well as increasing prana vayu (11).

Brahmi (Bacopa monnieri)

Brahmi has a long history of use in Ayurveda for rejuvenating the brain, memory and central nervous system (11). Its tastes are bitter, sweet and astringent so can pacify all doshas but if used in excess can aggravate vata. It has a post digestive sweet taste so nourishes all dhatus but especially rasa (plasma), rakta (blood) and majja (nerve) (7).

It is a cooling herb so is good for disturbances of Sadhaka pitta or excess heat which may manifest as inflammation in joints but in excess can aggravate vata (11).

It can be beneficial for anxiety, insomnia, Alzheimer’s, Parkinson’s and dementia. It increases resilience to stressors and helps guard against nervous exhaustion (7).

Guggulu (Commiphora mukul)

Guggulu is very rarely taken by itself, it is mixed with other herbs to enhance and guide them to a specific action in the body. It has strong rejuvenating and detoxifying qualities. It can travel deep in to the dhatus rejuvenating them as well as scraping and clearing toxins. It has an affinity for all the dhatus as well as the digestive, circularity, nervous and respiratory systems. (11) It pacifies all doshas but particularly kapha and vata. Guggulu has a remarkable ability to support balanced cholesterol levels. (7).

Guggulu is made from the sap of the mukul myrrh tree. Saps have an affinity with rakta dhatu (blood). Guggulu helps to purify the blood, support healthy cholesterol levels and scrape toxins from the circulatory system (12). It inhibits the formation of clots, reduces atherosclerosis, helps prevent heart disease and reduces the risk of stroke. It also helps remove toxins from the joints helping to relive any joint complaints. It’s bitter and pungent taste make it excellent for digestion and fat metabolism (7).

Arjuna (Terminalia arjuna)

Arjuna is a good heart tonic for the elderly or people with a history of heart issues as it has no known secondary effects. It balances all three doshas, can thin the blood, lower cholesterol and improve circulation without disrupting the ability of the blood to coagulate. It regulates blood pressure, strengthens the walls of the blood vessels (Raktavahasrota) and can strengthen the heart. (11)

Gotu kola (Centella asiatica)

Gotu kola is a medhya rasayana, it enhances memory, concentration and protects against degenerative aging process such as Alzheimer’s. It helps to relieve stress, anxiety and mental unrest. It is a cooling herb that is excellent for high Sadhaka pitta. Its bitter and astringent qualities make it an excellent detoxifier and anti-inflammatory which is beneficial for arthritis, gout and skin issues. Its sweet qualities help to support the adrenal glands and rebuild energy reserves. It is also a good herb for circulation being particularly beneficial after surgery by stimulating the microcirculation to the area to help healing (7).

Ayurveda formulas

Triphala (Terminalia chebula, Terminala belerica and Emblica officinalis)

Triphala

Triphala is probably the most well-known ayurvedic formula. Triphala balances all three doshas, is an excellent bowel cleanser that helps support regular bowel movements. It stimulates agni (digestive fire) improving digestion and absorption. It is also a powerful antioxidant.

Triphala consists of three fruits:

Haritaki: Good for all three doshas, has a scraping effect to help remove ama (toxins)
Amalaki: Has a cooling effect that helps reduce pitta. It supports the liver and immune system
Bibhitaki: Good for reducing kapha accumulations and the respiratory system.

Chyavanprash

Chyavanprash also called chyawanprash is a nourishing jam that has been used in Ayurveda for thousands of years and is of great benefit to elderly people. In Ayurveda jams are often used as anupans (carriers) for other herbs, but they are also often used on their own as rejuvenates. It is said that it was formulated by two ancient sages of Ayurveda to restore youth to the elderly sage, Chyawan (13).

The main ingredient is amalaka which is high in vitamin C. Other ingredients include long pepper, bamboo manna, cloves, cinnamon, cardamon, ghee, sesame seed oil and raw sugar (7).

The sesame seed oil and ghee carry the herbs deep in to the dhatu and are called yogavahis (catalytic agents). The sugar acts as a preservative.

It is very nourishing, helps to build ojas and balance vata. It is highly regarded rasayana as it strengthens and revitalizes the whole system in elderly health. (13)

Holistic solutions

Diet

The principle rasayana is food which is the foundation of all other rasayana therapies (7).

It is important to choose wholesome, constitution specific foods that keep agni and the doshas balanced. Ensure all food is freshly prepared. Rejuvenating foods that nurture ojas tend to be heavy and nourishing so can be hard to digest. Balancing agni must be addressed first (10).

Maintaining a balanced agni is key to preventative health. A balanced agni is required to nourish the dhatus to build ojas. During old age the dhatu’s cannot be enhanced but they can be protected and rejuvenated (11).

Support agni by including digestive spices such as turmeric, ginger, cumin, coriander and fennel. Kichari and bone broths are easy to digest and nourishing (7).

There are many rejuvenating foods that also help to pacify vata. Boiled milk is good for debility and convalescence and strengthens ojas. Ghee is the best food for restoring vitality, nourishing the nerves and increasing ojas. Grains such as wheat, oats and rice provide strength. Sweeter fruits and vegetables help increase strength, vitality and build dhatus e.g., dates, raisins, figs, pomegranates, okra, and root vegetables. Jaggery (pure cane sugar) is full of minerals to help build dhatu plus adequate salt intake is required for a tonifying diet (10).

Mindful eating is also very important. All focus should be on the food and not electronic gadgets or the TV. Eat slowly and eat until almost full. Overeating places a strain on the digestive system. Only eat if hungry, eat the largest meal at lunchtime when the sun is high in the sky, don’t eat late and try to eat at the same regular times each day (7).

Lifestyle

During Rasayana therapy relaxation is important. Excess work should be avoided, go to bed early, avoid over stimulation of the senses from social media or TV. Gentle exercises such as yoga or Qi Gong will help to build energy, move the lymphatic system and help the body remove wastes. (11)

Pranayama breathing exercises should be practised to cleanse the mind, increase ojas, balance vata and stimulate agni. Spending time in nature is extremely important as this is the best way to rejuvenate the mind. (11) Abhyanga oil massages aid detoxification, pacify vata and nourish the nervous system. (7)

Dinacharya (daily routine)

This is important to maintain harmony within body and mind that is in tune with the cycles of nature. This helps to keep doshas balanced.

Panchakarma

Panchakarma is a deep and thorough cleanse to remove ama and excess doshas. It is very effective at relieving deep seated diseases and for improving physical and mental health, and elderly health. An annual panchakarma by a qualified practitioner is recommended.

References

Deshpande, D., n.d. Jara Chikitsa in Ayurveda. [online] Gamrc.org. Available at: <http://gamrc.org/seminar/art/2/F1.pdf> [Accessed 12 July 2022].
Rao RV. Ayurveda and the science of aging. J Ayurveda Integr Med. 2018 Jul-Sep;9(3):225-232. doi: 10.1016/j.jaim.2017.10.002. Epub 2017 Dec 21. PMID: 29276113; PMCID: PMC6148064.
M. Agrawal et al. Concept of Jara and its correlation to Geriatrics. International JOurnal of Pharmaceutical and Medicinal Research. 2014; 2(6):165-168
Smith, V., 2016. Anatomy and Physiology in Ayurveda Dietekon, Switzerland: EIVS Gmbh
Who.int. n.d. Ageing and health. [online] Available at: <https://www.who.int/news-room/fact-sheets/detail/ageing-and-health> [Accessed 15 July 2022].
McIntyre, A., 2012. The Ayurveda bible. Alresford: Godsfield.
McIntyre, A., 2012. The Ayurveda bible. Alresford: Godsfield.
Upadhyay AK, Kumar K, Kumar A, Mishra HS. Tinospora cordifolia (Willd.) Hook. f. and Thoms. (Guduchi) – validation of the Ayurvedic pharmacology through experimental and clinical studies. Int J Ayurveda Res. 2010 Apr;1(2):112-21. doi: 10.4103/0974-7788.64405. PMID: 20814526; PMCID: PMC2924974
Doshi GM, Une HD, Shanbhag PP. Rasayans and non-rasayans herbs: Future immunodrug – Targets. Pharmacogn Rev. 2013 Jul;7(14):92-6. doi: 10.4103/0973-7847.120506. PMID: 24347916; PMCID: PMC3842000.
. McIntyre, A., 2007. Positive Health Online | Article – Rasayana: The Ayurvedic Path to Rejuvenation. [online] Positivehealth.com. Available at: <http://www.positivehealth.com/article/ayurveda/rasayana-the-ayurvedic-path-to-rejuvenation> [Accessed 14 July 2022].
Smith A.,2009. A Textbook On “Dravyaguna for Westerners” Dietekon, Switzerland: EIVS Gmbh.
Pole, Sebastian. Ayurvedic Herbs: The Principles of Traditional Practice. Churchill Livingstone, 2013. (189-190)911-192, 304-311.13.
Upadhyay AK, Kumar K, Kumar A, Mishra HS. Tinospora cordifolia (Willd.) Hook. f. and Thoms. (Guduchi) – validation of the Ayurvedic pharmacology through experimental and clinical studies. Int J Ayurveda Res. 2010 Apr;1(2):112-21. doi: 10.4103/0974-7788.64405. PMID: 20814526; PMCID: PMC2924974
hMishra, Y., Vijay, N., Krunal, T., Nagaraj, B. and B., S., 2016. Role of Rasayana in Geriatric Care – A Review. Journal of Ayurveda and Integrated Medical Sciences (JAIMS), [online] 1(1). Available at: <https://www.researchgate.net/publication/308955373_Role_of_Rasayana_in_Geriatric_Care_-_A_Review> [Accessed 14 July 2022].
Diagnose-me.com. n.d. Premature/Signs of Aging – Symptoms, Diagnosis and Treatment. [online] Available at: <https://www.diagnose-me.com/symptoms-of/premature-signs-of-aging.php> [Accessed 22 July 2022].

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