The more I live the more I realize I don’t know.
The more I practice medicine, the more I realize I don’t know. The more I realize God does know.
Yard to Table is a category of blog posts through which I seek to highlight readily available natural therapies all around us. Not only do natural therapies work, I will highlight the mechanisms of their actions found in the science.
A recent personal experience highlights the power of natural healing right around us.
The word physician is translated—to heal. How far has the medical profession fallen. About 4-5 weeks ago, I was out in my gardens pulling up the summer crops, prepping them for the winter months to come. I developed a rash on my legs and arms. I have a significant allergy to poison ivy. This was not poison ivy, but poison oak. If anyone has encountered this horrible shrub, they will understand my personal disdain for this shrub. With the help of topical lavender essential oil, the itching and the rash went away. However, 1-2 weeks later I developed a significant rash on my face. My attempts to treat the rash naturally led to no resolution of the rash. In fact, the facial rash only continued to increase. The only short-term benefit was found in the use of topical silver, though drying was the only real benefit. The volume and scope of the rash was not changed for the positive. A 1-2 week rash turned into a 3-4 week rash. What to do?
Being a physician, I reviewed my dermatologic diseases. Because of course, in my mind, I had leprosy and was falling apart—dermatologically speaking that is. There was topical dermatitis, there was eczema, there was fungal dermatitis, there was lupus, don’t forget psoriasis…many options were possible and the majority of them pointed to unknown causes and recommended treatments of topical and/or systemic steroids. I refused to blindly throw steroids at my body over an unexplained rash that wouldn’t go away—I don’t believe in band-aids and steroids are over employed dangerous band-aids. Just as I was about to give in, it took my wife to state the obvious—“That rash on your face looks just like the rash on your legs 5-6 weeks ago.” My frustration and impatience on the rash resolution had caused me to focus on disease and their associated treatments and to miss the glaringly obvious connection—I had poison oak on my face! How do know I know it was poison oak? I know it was poison oak due to the presence of that mess of poison oak in my back yard. I hope I have been able to reflect my disdain for this shrub.
It was at that point, that I turned to the essential oils for the treatment of my facial poison oak. The lavender had previously helped to resolve the itching due to the poison oak on my leg, but what about the unsightly rash on my face? The rash on my leg could be hidden with clothes, but the rash on my face could not. I expanded on the lavender that I used for the leg outbreak and added in a blended essential oil called R.C. Other topical essential oils effective against poison oak/ivy included: Lemon, Melaleuca, Roman Chamomile, and German Chamomile. Within 3 days, my facial rash was significantly better. Not completely healed, but on the way to complete healing via a natural approach. It took 3 weeks for complete resolution of the rash—It was a bad rash.
But how? What is the mechanism? How do essential oils heal poison ivy, poison oak, and/or poison sumac? The FDA doesn’t believe in natural therapies but science does.
To answer these questions, we must look to the science on inflammation. The cardinal symptoms of inflammation are heat, pain, edema, and redness. Each of these were present on my face. The rash on my face was the result of a localized reaction to inflammation resulting from contact with the offending poison oak. How does lavender interact with inflammation? Lavender reduces inflammation. How? Though the direct evidence of Lavender as an anti-inflammatory is limited, Lavender has been shown to:
- reduce Lipopolysaccharides (LPS) induced inflammation
- inhibit the inflammatory cytokine IL-1beta induced by LPS
- inhibit the inflammatory transcription factor NF-kappaB induced by LPS
The presence of one study presented above cannot discount the wide reaching effects of this anti-inflammatory activity of Lavender. For example, LPS has been shown to lead insulin resistance and metabolic syndrome through a process called metabolic endotoxemia. Not that Lavender can be used to treat metabolic syndrome, but that LPS has powerful, wide spread metabolic effects and Lavender has been shown to reduce inflammation secondary to LPS. Increased IL-1beta has been shown to be associated with a wide spectrum of diseases (autoimmune, cancer…). Interleukin-1beta is the inflammation that results from LPS. Chronic and increased NF-kappaB activation has been associated with just about every disease that one can think of. Anything that decreases chronic activation of NF-kappaB will reduce inflammation and improve the overall health of the individual.
The majority of data on inflammation and Lavender is around wound healing. For example, Lavender has been shown to be effective in the healing of episiotomies and in reducing post-cesarean section pain. Other anti-inflammatory and healing properties of Lavender are anecdotal and observational, but one can’t discount observation because observation is the heart of science.
More information is forthcoming when the constituents of Lavender are examined. It is important to understand the underlying biochemistry of action by these constituents. Many claim there is no science behind “natural therapies”, yet the science proves otherwise. I actually find more therapies based on no or little science in traditional medical practices than in the more natural medical practices. Just because physicians, medical groups, or the FDA don’t read and know the science, doesn’t mean that the science doesn’t exist. Out of sight, out of mind is not reality here–but that is what they would have us all believe.
The 2 primary active constituents of Lavender are Linalool and linalyl acetate. These 2 monoterpenes have significant anti-inflammatory properties. Specifically, Linalyl acetate has been shown to decrease oxidative stress and regulate inflammation through the JNK and ERK signaling pathways (see diagram to right). JNK and ERK are types of Mitogen Activator Protein Kinase pathways (MAPK). These pathways are important in regulating cellular growth, yet when improperly stimulated abnormal cellular growth can result. The JNK and ERK pathways are important in regulating inflammation signaling through the inflammatory transcription factor NF-KappaB. The regulation is complicated. The JNK pathway can increase NF-kappaB transcription/production and thus increase inflammation signaling, whereas JNK pathway activation can actually inhibit NF-kappaB and thus reduce inflammation. In the same, the ERK pathway activates NF-kappaB transcription/production and thus increases inflammatory signaling. The ERK pathway is important in regulating cellular inflammatory signaling, but when improperly stimulated, the ERK pathway can actually play a critical role in malignant transformation. As with everything, there is a dose-dependent response for JNK and ERK in inflammation regulation.
Not to be left out, Linalool has been shown to decrease the pro-inflammatory cytokines TNF-alpha and IL-6 throughout increased Nrf-2 activity. Tumor Necrosis Factor alpha (TNF-alpha) and Interleukin 6 (IL-6) are communicating signals of inflammation within the immune system. Increase in TNF-alpha, IL-6 and other inflammatory signals are commonly associated with increased biologic dysfunction and disease. Nuclear factor-erythroid 2 related factor 2 (Nrf-2) is a class of compounds that reduce oxidative stress. Think of oxidative stress as biochemical rust of a car. The function and appearance is still the same, but rapid biochemical degradation is underway. The car still works, but it doesn’t work as well, or looks as good as it once did. In short, oxidative stress induces rapid aging. Additionally, activation of Nrf-2 has been shown to increase glutathione production (see diagram below). Glutathione is probably the most potent detoxifying chemical the body makes.
The other essential oil was R.C. R.C. is a blend of Eucalyptus, myrtus, pine, marjoram, peppermint, and you guessed it—Lavender. What about the other essential oil–R.C.? The R. C. blend contains several varieties of Eucalyptus species that have been shown to reduce pain (remember that pain is one of the 4 cardinal symptoms of inflammation) and reduce inflammation itself. The well know peppermint more than smells good, peppermint has been shown to reduce the symptoms of IBS. IBS is simply unidentified gastroenteritis or better translated–inflammation of the gastrointestinal tract. The oil of marjoram, Origanum majorana,
from has been shown to reduce TNF-alpha, a potent pro-inflammatory cytokine.
The problem with natural therapies is not the natural therapies themselves or their effectiveness, but the lack of large volumes of scientific evidence on their effectiveness. This limitation has not stopped traditional medical therapies. Just look at the volume of data on Testosterone therapy in women–it is small and biased. Yet, this low volume of evidence on efficacy, lack of long-term safety data, lack of understanding of the physiologic effects of Testosterone in women in the face of data that points to increasing endogenous Testosterone and inflammation, cardiovascular disease, and cancer hasn’t stopped the large movement of Testosterone therapy in women. Who is not following the science again?
Why the paucity of data? Simply stated-money and control. Money, because it takes millions upon millions of dollars to bring drugs to the market with FDA approval. It has been estimated to cost as much as $800,000,000 to get a drug through phase I, phase II, and phase III to receive FDA approval. Then to repeat this process to increase the volume of data seems like an impossible task. It will continue as long as a company cannot patent natural therapies (as they should not be able) and or profit margins are low. Lets face it, the profit margins on natural therapies are much lower than traditional pharmacologic therapies. Just look at coconut oil. Coconut oil has been suggested, by research, to be beneficial in those battling Alzheimer’s disease. Over the counter coconut oil can range from $20 to $30 for high end coconut oil, yet there is a prescription blend of coconut oil that runs $80 plus, and that $80+ price requires a coupon from the manufacturing company. Then consider that this prescription coconut oil blend has 2 grams of sugar and sucralose in it and one sees the utter uselessness of this product, yet its profit margin is huge. Most people are being prescribed this prescription coconut oil, axona, for Alzheimer’s disease and 2 grams of glucose and the artificial sweetener sucralose is the last thing you want to give to someone with Alzheimer’s disease. See the different in cost and profit margin and one can see why there is a paucity of large volume of studies on natural therapies.
The other reason for a lack of paucity of data and studies in general is control. There is a lot of control gained if therapies can only be obtained from a physician’s office through FDA regulation. Likewise, there is a lot of control lost if therapies can be purchased right over the counter. It is easier to control physicians than the entire population of the US—simply less numbers.
What I am not saying here is that essential oils, in this case Lavender and R.C., treat skin diseases like psoriasis or lupus. What I am saying is that Lavender and R.C. reduce inflammation. Even better– I am simply highlighting the scientific research that points out the mechanism(s) by which the active constituents of Lavender and R.C. reduce inflammation. It just so happens that inflammation is present in all disease. I am not stating an opinion, I have simply pointed out scientific evidence.
No therapy, even natural therapies, is without the risk of side effects. Even Lavender can irritate the skin of some people. A lot of this is due to different skin types and sensitivities. Some people are just sensitive or even allergic to Lavender. If you just have sensitive skin, try diluting the lavender with olive oil and see if that doesn’t resolved the problem. Prior to wide spread application, apply the Lavender to a discrete area to see if any topical reaction occurs. But for most, the sensitivity to Lavender is due to the presence of other irritants in the Lavender. All Lavender is not created equally and that should surprise no one. The addition of artificial chemicals to Lavender are the usual culprits of sensitivities to Lavender for most people.