Herbal Remedies Natural Health Newsletter, October 2003, Issue 220

• Autumn is prime time for exposure to poison ivy, poison oak and poison sumac. Learn how to identify these annoying plants with treatment options - Click here for full story.

• Hair loss is no laughing matter - Click here for full story.

• Creatine, used by athletes for quick bursts of energy, is the star player in clinical trials currently underway by the Muscular Dystrophy Association - Click here for full story.

• Questions and Answers

• Q1. "I have chapped lips that never seem to heal." - Click here for full story.

• Q2. "If a tincture says for external use, how is it to be applied for an internal condition?" - Click here for full story.

• Q3. "I have bad migraines and depression. Can you help?" - Click here for full story.

• Our Sponsors

As autumn gradually paints the landscape full of color, the most vibrant plants are among those that should be admired from a safe distance. Especially if you are one of the 1.8 million Americans who are highly allergic to poison ivy, poison oak and poison sumac.

Those who are overly sensitive to these poisonous plants can break out in a rash and begin to swell within as little as four hours following exposure. According to the American Academy of Dermatology, this is one of the few true emergencies in dermatology when getting to a hospital as soon as possible is crucial where a shot of corticosteroids can bring life-threatening swelling down.

LEAVES OF THREE

While “Leaves of Three – Let Them Be” is a good mantra for anyone to live by, it should be modified to say, “Leaves of Three – or Odd – Let Them Be”. Poison ivy and poison oak both have three leaves; poison sumac can have anywhere from seven to 13 leaves. The villain that puts the poison in poison ivy, poison oak and poison sumac is urushiol oil. All three of these plants emit urushiol, which is an oily irritant found on the plant's stem, roots, branches and leaves.

When touched, urushiol chemically "locks on" to skin proteins within as little as 20 minutes after exposure to the plants. Exposure includes contact with live plants as well as dormant plants or long-dead prunings, contaminated clothes or tools, or even contaminated pets.

It is hard to avoid these plants since at least one if not all three can be found in every state within the United States, with the exception of Alaska and Hawaii. Even the early settlers had to contend with urushiol. The first published records of poison ivy in North America date back to 1609 when Captain John Smith first encountered the plant.

Poison ivy, poison oak and poison sumac are so prevalent and can cause such severe reactions that, in some states like California for example, exposure is covered by workers compensation. Contact with these annoying plants can produce a rash in three out of four people. It is the most common allergy in the country, claiming half the population. About 85 percent of all people will develop some type of an allergic reaction when adequately exposed to poison ivy. Mild cases can last five to 12 days, while more severe cases can last up to 30 days or longer, due to re-exposure.

HIGHLY POTENT – VERY RESILIENT

Urushiol is highly potent. Five hundred people could itch from the amount of urushiol that covers the head of a pin. There is enough oil on a stem to infect more than 10,000 people.

All of the tissues of poison ivy, poison oak and poison sumac plants contain urushiol, which is somewhat like carbolic acid. The oil is extremely irritating to the skin. It may be brushed onto the clothing or skin of people coming in contact with the plants. Merely taking off their shoes after walking through poison ivy, in fact, has poisoned many people.

Not only is it potent, it is also very resilient. One to five years is normal for urushiol oil to stay active on any surface, including dead plants. And since oils do not evaporate, it can remain active for a year or longer after being picked up on tools, clothing or animal fur.

Urushiol oil also tends to be absorbed by the body more readily because it is so heavily concentrated. Exposing an open cut, even a mosquito bite, to the plant allows the oil direct access into the blood system.

HOW TO IDENTIFY PLANTS

The best way to avoid poisoning is to avoid the plants. Poison ivy is a vine or shrub in the cashew family. It grows plentifully in parts of the United States as well as southern Canada. It usually grows as a vine on tree trunks or straggling over the ground. The plant will form upright bushes if it has no support to climb upon.

The leaves of poison ivy are red in early spring. In the summer, they change to shiny green. In the autumn the leaves turn bright yellow, red or orange. Each leaf is made up of three leaflets more or less notched at the edges. Two of the leaflets form a pair on opposite sides of the leafstalk, while the third sits at the tip of the leafstalk. Small greenish flowers grow in bunches attached to the main stem close to where each leaf joins it. Later in the season, clusters of berry form. The berries are first green and then turn to white with a waxy varnish.

Poison oak and poison sumac are species closely related to poison ivy. They all resemble each other. Poison oak grows in the Pacific Northwest and nearby regions of Canada. Poison sumac usually grows in the eastern United States. Both are shrubs.

It is estimated that 90 percent of people are allergic to urushiol oil. Also one must not assume they are not allergic - it's generally a matter of time and exposure. The more times one is exposed to urushiol, the more likely a break out with an allergic rash will occur. For a first time sufferer, it can take longer for the rash to show up - possibly seven to 10 days.

According to the American Academy of Dermatology, direct contact is needed to release urushiol oil. While people can get poisoned from other people, this can only happen if the oil remains on the skin. The eruptions themselves cannot infect another person.

Direct contact is achieved by touching the plant or it can be contracted by air if the oil is airborne. For this reason it is wise to stay away from forest fires, direct burning, or anything else that can cause the oil to become airborne such as a lawnmower or trimmer.

Efforts have been made to destroy these plants by uprooting them or by spraying them with chemicals. But poison ivy, poison oak and poison sumac are so common that such methods have not been very effective in eliminating them.

AFTER EXPOSURE

Once direct contact with urushiol has been made and the oil has touched the skin, it can take less than a half-hour for the oil to penetrate and do its damage. Before this happens, it is wise to wash the skin thoroughly several times with plenty of soap and water. Care should be taken not to touch any part of the body, for even tiny amounts of the oil will cause irritation.

If poisoning develops, a rash may begin within a few hours, or it may not appear until three to five days later. The rash starts with itchiness and swelling followed by a reddish inflammation of tiny pimples. Blisters then form and then couple in a chain-like reaction, often arranged in streaks or lines where the person brushed against the plant. In a few days, the blisters become crusted and can take 10 days or longer to heal. If left untreated, the rash (a typical histamine response) will last three to five weeks.

While breaking the blisters does not release urushiol oil, breaking the blisters should be discouraged since the wounds can become infected. Scarring may occur. In very extreme cases, excessive fluid may need to be withdrawn by a doctor.

STEPS TO TAKE

Within five minutes of exposure:

• Rinse with water (and soap if available) to try to get the oil off.

Within a half-hour of exposure:

• Wash the skin with both soap and water
• Apply rubbing alcohol with cotton balls or alcohol wipes to the parts of skin that are affected.
• Try an over-the-counter product known to remove urushiol oil.

If a rash develops:

• Take a cold shower or pour cold water on the rash so water can run off. Use soap when showering. Do not take a bath or use hot water, since these will only agitate the itching.
• Take an antihistamine, such as Benadryl, to stop itching.
• Cover weeping blisters with wet gauze that has been dipped in a mixture of two teaspoons of baking soda and one quart of water or make a paste with three teaspoons of baking soda mixed with one teaspoon of water.
• The blisters and red, itching skin may also be treated with Calamine lotion (Note: Caladryl is not recommended), Epsom salts or bicarbonate of soda. Over-the-counter hydrocortisone creams are not strong enough to have much effect on poison ivy rashes.
• Soaking in a cool bath with an oatmeal or baking soda solution may also ease itching and dry oozing blisters.
• Keep hands away from eyes, mouth and face.
• Do not scratch or rub the rash.
• Be sure to wash clothing or any other item that may have come in contact with the plant so the oil does not linger.

Jewelweed is one of the most effective natural remedies for poison ivy. It is a wild impatiens that often grows near poison ivy. Native Americans explained this by saying, “The Great Spirit put the remedy next to the problem.”

Simply blend dry skin cream with jewelweed leaves, aloe vera gel, Vitamin E and Vitamin A. For more information on Jewelweed, click here.

SENSITIVITY DECREASES WITH AGE

Sensitivity to poison ivy tends to decline with age. Children who have reacted to poison ivy will find that their sensitivity decreases by young adulthood without repeated exposure. People who were once allergic to poison ivy may even lose their sensitivity later in life.

Click here to learn more about poison ivy.

PATIENT: Doctor, my hair keeps falling out. What can you give me to keep it in? DOCTOR: A shoebox.

Hair loss, also known as alopecia, is oftentimes the brunt of many jokes, but for someone experiencing it - it is not funny. And although hair performs no vital function to a person’s medical well being, its loss can have serious psychological implications.

To some extent, scalp hair is one of the few attributes that can be somewhat controlled. Thanks to a wide selection of hairstyles, beauty products and tools, such as blow dryers, curling irons and straightening rods, a full head of picture perfect hair is most everyone’s goal.

LOSING SOME HAIR IS GOOD

It is normal to lose anywhere from 50 to 100 hairs a day. This is part of a three-stage re-growth process that hair undertakes – a process that can take anywhere from two to six years.

After growing, hair enters a short transition stage, and then a resting stage. At any one time, about 10 percent of the hair on the scalp are in a resting phase. At the end of the resting phase - generally two to three months - the resting hair falls out resulting in shedding. New hair starts to grow in its place and the cycle starts all over.

While shedding is part of the normal process, losing more than 100 hairs per day may indicate a disorder.

IF LOSING TOO MUCH

Hair disorders are extremely common, with problems ranging from hair loss to hair fragility to hair overgrowth, according to the North American Hair Research Society. Hair loss, or alopecia, may involve genetic abnormalities that lead to hair loss in childhood or adulthood, or non-genetic acquired abnormalities from drugs, infections or hair care practices.

Effective treatment of any one of these conditions requires a correct diagnosis. A dermatologist with expertise in hair problems should be consulted. A diagnosis can then lead to very specific treatment options, including any potential to reverse hair loss or contain the hair loss, costs, or even the possibility of a hair transplant, as well as anticipated time it will take to respond to a specific treatment.

SOME CAUSES OF HAIR LOSS

Hair losscan occur rapidly or gradually. If it occurs rapidly, medical advice should be sought immediately since rapid hair loss might be an indication of an underlying disease. If the loss occurs over a long period of time, chances are the loss is attributed to heredity, hormones and aging.

Both men and women lose hair. However, hair loss in men is often more dramatic. Ninety-five percent of hair loss in men follows a specific pattern known as "Male Pattern Hair Loss"(MPHL). Male hormones, androgens, play an important role. The male hormone dihydrotestosterone (DHT) specifically can cause progressive miniaturization of the hairs on site. This progressive loss of hair eventually results in the thinning or loss of hair at the front or top of the scalp.

MPHL can begin anytime after puberty, but most commonly begins among men in their mid-twenties, according to the American Medical Association (AMA). It affects roughly 40 million men in the United States. Approximately 25 percent of men begin balding by age 30; as many as 50 percent of men are affected by MPHL by age 50; and two-thirds begin balding by age 60. Male pattern hair loss is caused by genetic and hormonal factors, as well as aging. The genetics can be inherited from either the maternal or paternal sides of the family.

Factors for female hair loss also include heredity, hormones and aging, but hair loss in women is often to a lesser degree than that of men. Women can also experience loss of hair within a couple of months after having a baby or following menopause.

Other factors that can contribute to hair loss include:

• poor diet
• poor circulation
• acute illness
• radiation or chemotherapy
• high stress
• thyroid imbalance
• certain drugs such as anticoagulants, lithium and beta blockers
• hormone imbalance, one example is going off the contraceptive pill
• diabetes
• high doses of vitamin A (more than 100,000 IU)
• sudden weight loss
• high fever
• iron deficiency
• some fungal infections such as ringworm
• chemicals like hair dyes
• vitamin deficiencies
• insufficient intake of protein
• lack of proper nutrition
• autoimmune diseases such as thyroiditis, Addison's disease and pernicious anemia (Vitamin B-12 deficiency).

The condition of the underlying scalp can provide answers as to why hair loss is occurring – especially if the loss occurs rapidly. In some cases a skin biopsy of the scalp may be required to establish the diagnosis and to guide treatment, thus further increasing the importance of seeking professional medical advice before self-diagnosing a hair loss problem.

Nail abnormalities are also commonly seen in association with hair loss and can offer a clue as to why the loss is occurring. Some researchers have reported a worse prognosis if severe nail changes are present. Changes to the nails may include thinning of the nail plate and severe pitting and ridging.

According to the AMA, it should be noted that contrary to popular belief, balding is not caused by wearing hats. Massaging or brushing the scalp will not help re-grow hair and excessive cleaning of the scalp will not "unclog" follicles allowing hair growth. Also while extreme psychological stress may contribute to a form of hair loss, normal everyday stress does not contribute to balding and is not a cause.

AVAILABLE TREATMENTS

While there is no cure for baldness - that is if a non-genetic cause has been ruled out - there are medications commonly prescribed to promote hair growth or to reduce the inflammatory reaction around hair follicles. Treatments available include a topical minoxidil solution (Rogaine®), an oral finasteride (Propecia®) and hair transplantation or grafting. A dermatologist will be familiar with these and can discuss the pros and cons of each.

In addition, several natural treatments may also be discussed and recommended.

• Topical natural hair loss prevention and re-growth treatments by Nisim are clinically proven and have shown to be very effective as a topical daily treatment for reducing hair loss and the re-growth of hair lost within the past two to five years.
• Essential fatty acids found in flax seed oil, primrose oil or fish oil are supportive of hair texture and prevent dryness.
• General nutrition and vitamin deficiencies that increase hair loss and limit hair growth may be improved with a good multivitamin accompanied with iron.
• Keratin production for healthy hair is improved with MSM (methylsulfonylmethane), topical and internal applications, with the beneficial side affects of better skin and, when taken internally, MSM reduces joint pain associated with various forms of arthritis.
• B complex vitamins are essential for healthy hair growth and stress reduction.
• Vitamin E d-alpha-tocopherol increases oxygen uptake, which improves blood circulation to the scalp improving health and growth of hair.
• Zinc stimulates hair growth by enhancing immune function, best absorbed in a lozenge.
• Various amino acids support hair growth and stop hair from falling out such as L-methionine.

As baby boomers age and more of the population experiences hair loss, the condition is evolving from that of being the brunt of jokes to one that is now being taken seriously. In fact, the National Institutes of Health, along with the Institute of Arthritis and Musculoskeletal and Skin Diseases, has funded a major project called the Alopecia Areata Registry.

The registry is a network of five centers that are in the process of identifying and registering patients with hair loss. Data and blood samples are being collected and will be made available to researchers studying the genetic basis of alopecia areata and other aspects of the condition. (The term alopecia areata is used when there are round or oval patches of hair loss. Alopecia totalis refers to loss of all scalp hair. Alopecia universalis is loss of all scalp and body hair.)

The registry is seeking U.S. residents with one of the three types of hair loss as diagnosed by a dermatologist. For more information about the registry and to learn how to participate, log onto the registry web site at www.alopeciaareataregistry.org.

Also available within the near future will be topical sensitizers. When applied, new hair growth can be seen in three to 12 months – if this therapy is effective for a particular individual since all individuals might respond differently.

Three topical sensitizers to watch for are: dinitrochlorobenzene, squaric acid dibutylester and diphenylcyclopropenone. While these chemicals are available in the United States their use in management of hair loss has not been subjected to testing required by the Food and Drug Administration (FDA). It is anticipated that in the very near future however FDA testing will be initiated and volunteers may be sought.

For more information on hair loss, click here.

For years athletes have used creatine monohydrate for sports activities that require quick bursts of energy, such as sprinting, jumping, high intensity weight lifting and swimming. Now the muscle builder and sports performance enhancer might just help those with neuromuscular diseases. At least that is what researchers hope to find in a number of multi-center clinical trials now underway.

Neuromuscular diseases affect more than a million Americans. While there is no one single disease called muscular dystrophy, the term is given to a group of usually inherited disorders that result in a gradual wasting and weakening of muscle fibers. As mobility deteriorates, the pelvic muscles grow weak.

The clinical trails, funded by the Muscular Dystrophy Association (MDA), are in response to two promising scientific studies published in 1999. The studies indicated that creatine may be beneficial to those with disorders such as amyotrophic lateral sclerosis (ALS), more commonly known as Lou Gehrig’s disease, as well as other forms of muscular dystrophy, by providing energy to nerve endings.

SCIENTIFIC STUDIES OF CREATINE

In the first scientific study, M. Flint Beal of Cornell University Medical Center demonstrated that creatine was twice as effective as riluzole, an FDA-approved prescription drug currently in use, in extending the lives of mice with ALS.

The second study, conducted by Canadian researchers Mark Tarnopolsky and Joan Martin, McMaster University Medical Center in Ontario, found that creatine can produce modest increases in strength in people with a variety of neuromuscular disorders, including such muscular dystrophies as Myotonic, Becker, Limb-Girdle.

HOW CREATINE WORKS

Creatine is an amino acid - the building blocks of protein. It is naturally produced in the body by the liver and kidneys after digesting meat and animal products. It is then changed into phosphocreatine, which plays a vital role in energy metabolism by assisting in replacement of used energy. It also serves as a storage reservoir for quick energy.

For an athlete, a burst of energy can be useful when doing short-term intense exercises. For one with ALS or a similar neuromuscular disorder, creatine might just provide extra energy to weakened or damaged nerve cells, thus improving muscle strength.

CLINICAL TRIALS UNDERWAY

According to the Muscular Dystrophy Association Web site, there are at least three trials presently underway studying creatine.

• The first study is assessing the effectiveness and safety of creatine and glutamine, also an amino acid that stimulates the synthesis of proteins, inhibits their degradation and is an energy source for muscle cell division, as a possible therapy particularly for Duchenne muscular dystrophy, which affects boys.
• The second and third clinical trials are being held to determine the effects of creatine upon strength, lean body mass or muscle, function, safety issues and muscle phosphocreatine content, all to be determined by a non-invasive magnetic resonance spectroscopy, in Duchenne and Becker muscular dystrophies and Myotonic dystrophy. Canadian researcher Mark Tarnopolsky, who is credited with originally noting creatine’s potential in 1999, is involved in these trials.

The results of these studies are to be released later this fall.

CREATINE PLUS MINOCYCLINE

In even more hopeful news, the MDA is also looking at the effects of combining creatine with the antibiotic minocycline as a possible treatment for ALS. The adult-onset disease attacks muscle-controlling nerve cells, typically leading to paralysis and death within three to five years of diagnosis. Riluzole (Rilutek), the only FDA-approved drug for treating the disease, extends survival by just a few months.

Robert Friedlander, a professor of neurosurgery at Brigham and Women’s Hospital, a teaching hospital of Harvard Medical School in Boston, has spent years searching for more potent alternatives to riluzole. In a new study, he shows that mice with ALS given both creatine and minocycline develop the disease later and survive longer than mice given either drug alone.

Friedlander’s group reported last year that minocycline extends survival by about 13 percent in mice with ALS. Their finding was similar to that of the 1999 studies - showing that creatine has similar effects. Friedlander’s current work, published January 2003 in the Annals of Neurology, reproduces those findings and shows that minocycline and creatine together can extend survival of mice with ALS by about 25 percent.

The minocycline-creatine combination probably has an additive effect against ALS because each substance appears to target a distinct part of the disease process, Friedlander explained. His previous work showed that minocycline blocks an early event in nerve cell death. Creatine, a natural source of energy in the body, appears to boost energy levels in ailing nerve cells.

POSSIBILITY OF COMBINATION THERAPY

"Combination therapy may be the future of ALS treatment," said Friedlander. "This discovery may potentially influence novel drug therapy for other neurodegenerative diseases, such as Huntington's, Parkinson's and Alzheimer's, as well."

Friedlander and his team speculate that after the results of the trials testing both creatine and minocycline individually are published, a "cocktail" human trial will be the next logical step, and one that may bring researchers even closer to preventing the fast and deadly progression of ALS.

Click here for more information about ALS and creatine.

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