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Nutritional support for women over 50

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Black cohosh (Actaea racemosa)

This is good for menopausal symptoms, but needs a prescription from a registered naturo-path or medical herbalist (McKenna DJ et al. Botanical Medicines: The Desk Reference for Major Herbal Supplements, 2nd edn. London, Oxford & NY: The Haworth Press, 2002: 41-3). The herb can also help with postoperative functional deficits following ovariectomy or a full hysterectomy.

Contraindications: Pregnancy; lactation; oestrogen-dependent tumours, including some breast cancers due to its potential oestrogenic actions; and salicylate hypersensitivity, as this is a salicylate-containing plant.

Drug interactions: Hormone replacement therapy (HRT), as this herb may lead to oestrogen excess.

In studies using a fluid extract of this herb, up to 890 mg/day has been given-with no toxic effects (Brinker F. Herb Contraindications & Drug Interactions, 3rd edn. Sandy, OR: Eclectic Medical Publications, 2001: 40-1; also www.eclecticherb. com/emp), although the usual dose of an ethanolic extract is only 8 mg/day.

Evening primrose oil (EPO)

Postmenopausal women often suffer from dry skin (eczema-like), hair loss, breast pain and poor wound-healing due to depleted oestrogen. However, EPO (Oenothera biennis) can help to reverse these conditions (McKenna op.cit., 327-35).

Contraindications: Epilepsy; and mania.

Drug interactions: Phenothiazines: induces seizures and hallucinations; tamoxifen: speeds up clinical response; cyclosporine: less kidney damage; and anticoagulants: may enhance blood-thinning effects.

The highest dose generally recommended is 0.1 mL/kg/day, so someone weighing 55 kg (8.5 stone) should take 5.5 mL/day (Brinker op. cit., 92-3; see also

Garlic (Allium sativum)

It is well established that garlic lowers blood pressure, blood glucose, blood lipids and chol-esterol, but it also prevents blood clots, and is mildly antibiotic, antifungal, anticancer, antioxidant, immuno-modulatory and liver-protective (McKenna op. cit., pp 375-96).

Contraindications: Gastritis; early preg-nancy; hypothyroidism; and oesophageal reflux.

Drug interactions: Warfarin or other blood-thinners: because it enhances anticoagulation; indomethacin; dypiridamole; paracetamol/ acetaminophen: it may prevent liver toxicity; and insulin (as it lowers blood glucose, insulin doses may need adjusting).
A dose of 4 g/day of fresh garlic, or 8 mg of essential oil of garlic as support therapy, is typically prescribed to reduce blood lipids, and to prevent age-dependent vascular changes (Brinker, op. cit., pp 99-101).

Ginkgo biloba (maidenhair tree)

Ginkgo helps to prevent memory loss, loss of mental alertness, dementia, stroke, free-radical damage in traumatic brain injury and Alz-heimer’s (Arch Phys Med Rehabil, 2000; 81: 668-78).

Contraindications: Bleeding disorders, especially those with reduced blood-clotting, so it may contribute to haemorrhage if used for a lengthy period prior to surgery.

Drug interactions: Aspirin (when used chronically to prevent blood clots), anticoagulants, heparin, other non-steroidal anti-inflammatory drugs (NSAIDs), ticlopidine, thiazide, trazodone, cyclosporine and papaver-ine; it may enhance meclofenoxate, used to treat senile dementia and Alzheimer’s, and the effects of monoamine oxidase inhibitors (MAOIs), a class of antidepressant drugs.

In a study of 33 women taking an average dose of 209 mg/day, Ginkgo leaf extract counteracted the sexual dysfunction associated with antidepressants, mostly SSRIs (selective serotonin reuptake inhibitors), but also phenel-zine (an MAOI), vivactil (protriptyline, a tricy-clic), and venlafaxine, nefazodone and bupro-pion (serotonin-norepinephrine reuptake inhibitors, SNRIs) .

It is also thought that Ginkgo may reduce the efficacy of anticonvulsants such as carbamazepine (Brinker op. cit., pp 103-7).
Ginkgo is usually given as a total daily dose of 120-240 mg of the standardized extract [containing at least 24-per-cent ginkgo flavone glycosides and 6-per-cent terpene lactones (ginkgolides and bilobalides)] for at least eight weeks to treat chronic conditions, and a review of its benefits is typically carried out before it is taken for more than three months.

Harald Gaier

Please note that T. Voronina, endocrinologist, acupuncturist and homeopath, co-authored last month’s Alternatives.


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