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Nutritional support for women over 50

MagazineDecember 2010 (Vol. 21 Issue 9)Nutritional support for women over 50

Black cohosh (Actaea racemosa)

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 www.eclecticherb.com/emp).

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.

WDDTY VOL. 21 ISSUE 6


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