Herbal Antibiotics: Natural Alternatives for Treating Drug-Resistant Bacteria (25 page)

Artemisinin is also stimulating interest as an antitumor and anti-cancer compound. It has shown effectiveness as an anticancer agent both in vitro and in vivo. In vitro studies have found artemisinin effective against human leukemia cells, breast cancer, and colon cancer. Treatment of both bone cancer and cancer of the lymph nodes in dogs was effective with 10 to 15 days of treatment. The use of artemisinin in people with cancer has shown effectiveness as well; Vietnamese doctors have found it successful in curing 50 percent to 60 percent of several different types of cancer patients.

Clinical practice reports indicate the use of artesenuate in the successful treatment of non-Hodgkin's lymphoma (60 mg IM for 14 days), artemisinin for small-cell lung carcinoma (500 mg BID for 4 months), artesenuate (IV) and artemisinin (300 mg BID) for 4 months in the treatment of stage 4 breast cancer with metastases, topical artemisinin in the treatment of multiple skin cancers, oral artemisinin in the treatment of breast cancer with metastases to
the spine, and artesenuate in the treatment of stage 4 uveal melanoma.

A number of studies have found the herb to possess anti-inflammatory and antioxidant activity.

Artemisinin is immunostimulatory in vivo. It stimulates phagocytosis, and macrophages become more potent; they are better at phagocytosing malarial-infected erythrocytes.

There is increasing evidence that using the single compound artemisinin or any of its derivatives is stimulating resistance in the organisms it is being used to treat. Resistant malarial organisms have been found in Cambodia and are beginning to spread worldwide.

A recent study found that malarial organisms go into a dormancy state upon encountering artemisinin and then recover after dosing has ceased.

In consequence, many groups are beginning to use combination therapies to treat susceptible parasites, essentially artemisinin plus a pharmaceutical. It's known as artemisinin combination therapy or ACT.

The increasing resistance to artemisinin and its synthetic derivatives is a problem that cannot be solved through multidrug therapy: single constituent pharmaceuticals will
always
end up promoting resistance in disease organisms. A different approach is essential.

As I have already mentioned, there is a conflict between two ideologies in health care and medicine: 1) sustainable, affordable health care that empowers the people who use it; and 2) health care controlled by corporations for their own profit, a model that is designed to keep the people who use it dependent on specialists and corporate manufacturers. There is no way to avoid encountering, or dealing with, this conflict in some form if you explore the use of herbal medicines for your own health.

While the cost of artemisinin is low when viewed from Western, industrialized perspectives, in Africa it is prohibitively high. In 2004 the cost of a course of artemisinin was $2.40, more than most people in Africa can afford. As a result artemisinin forgery has become a lucrative business in Africa. Products that contain no artemisinin are widely available; they do nothing to cure malaria.

A number of NGOs (nongovernmental organizations) such as ANAMED (Action for Nature and Medicine), of which I am an admirer, have begun to address the problem in a simple and direct manner—they are providing artemisia seeds to anyone in Africa who wants them, teaching them how to grow the plant and how to use it to treat malaria. This has resulted in rather predictable responses from Western researchers, physicians, and corporate scientists. They oppose it and sometimes work quite strongly to stop it.

The primary argument being made is that the plant is not very effective against malaria, which of course ignores the reason artemisinin was
discovered in the first place—people who used it for medicine had little or no incidence of malaria in their communities. Some researchers go so far as to say the plant does not work at all,
only
the isolated constituent is effective. Jansen (2006) is a perfect example. He comments, “The herbal tea approach to artemisinin for malaria is totally misleading and should be forgotten as soon as possible.”
⁵

Thankfully, the reaction to such antiquated thinking has been strong.

RITAM (Research Initiative on Traditional Antimalarial Methods), a partnership between the Global Initiative for Traditional Systems of Health at Oxford University and hundreds of international researchers from over 30 countries who are exploring malaria treatment with traditional plants, responded to Jansen's comment this way: “We believe that this statement is totally misleading and should be forgotten as soon as possible.”
⁶
Their article then explains in depth how most Western researchers, in looking at
Artemisia annua
tea formulations, consistently fail to understand the plant or how it should be used in practice to be effective. It points out, as well, how Hansen's comments are fatally flawed.

Extensive work by RITAM and ANAMED has resulted in comparable tea preparations that are as effective in use as artemisinin.

The artemisinin content in the plant is strongly stable if it is properly stored (out of the sun in foil or plastic bags inside plastic tubs). Even after 1 year in storage, the artemisinin content is nearly identical to that in the freshly harvested plant. (Ceiling-hung plants will begin to degrade after 3 months.) The artemisinin is held in the glandular trichomes of the plant's leaves and flowers, where the essential oils of the plant are also held. These oils protect the artemisinin from degradation, oxidation, fungi, and molds.

Numerous researchers are suggesting that artemisinin combination therapy (ACT) is the best approach to treating malaria as the recrudescence rates are smaller and the parasite has a harder time developing resistance. But the plant already is an ACT substance. Researchers, using identical tiny amounts of
Artemisia annua
and artemisinin, found that these tiny amounts of
A. annua
reduced parasitemia in vivo by 50 percent at day 4, while the artemisinin was no more effective than placebo.

Other researchers, removing the artemisinin from the plant, found it still effective for malaria treatment.

There are other constituents in the plant that have been found to be synergists with artemisinin. Several flavonols have been found to be potentiating synergists with both berberine and norfloxacin in the treatment of MRSA, for instance. They apparently act as a multidrug-resistance efflux pump inhibitor (see
chapter 6
). These same flavonols have also been shown to potentiate the action of artemisinin against the malarial parasite. And both
Artemisia annua
and
Artemisia dracunculus
contain an essential oil, piperitone, that acts as a potentiator of nitrofurantoin against
Enterobacter cloacae
.

The number of synergists and potentiators in the artemisias seems large. The complex combination of multiple antiplasmodium constituents
and synergists makes the plant a potent choice for an, essentially, free treatment for those who need it, or want it as the treatment of choice.

There have been a number of clinical trials in the use of the tea (or whole herb or tincture) in treating malaria. Studies have shown that the pharmacokinetics of the herb's artemisinin when taken as a tea are identical to those of artemisinin taken as an isolated constituent:

Clinical trial with tincture:
72 grams of crude extract in divided doses over 3 days in the treatment of 485 cases of
Plasmodium vivax
and 105 cases of
P. falciparum
. Clearance rate was 100 percent, but the patients were not followed for recrudescence.

Clinical trial with whole-herb infusion:
93 percent clearance rate in 254 patients using a 7-day course of whole herb infusion (tea) in the treatment of
P. falciparum
. Recrudescence rate was 13 percent after 1 month.

Clinical trial with capsules:
Clinical trial of 165 people infected with
Plasmodium vivax
. Fifty-three were given capsules of
A. annua
that also contained oil (COEA) for 3 days (the oil enhances absorption of the artemisinin). Another 50 received the herb capsules with oil (COEA) for 6 days. Forty-one received capsules without the oil (QHET). Twenty-one received chloroquine. Dosage was 36.8 grams on the first day, 18.4 on subsequent days. Parasite clearance and fever reduction were faster with the capsules than with chloroquine. There was a 30-day follow-up with blood checks every 10 days. About one-third of those who took the COEA herb capsule for only 3 days or who took the non-oil capsules (QHET) experienced recrudescence. Those who took COEA for 6 days experienced about 8 percent recrudescence. There was no recrudescence in the chloroquine group.

Clinical trial with infusion:
An aqueous infusion for 5 days in a small trial of five people found 100 percent clearance; no follow-up occurred to check for recrudescence.

Clinical trial with infusion and decoction:
A trial using infusions (254 people) and decoctions (48 people) with 5 grams herb in 1 liter of hot water, infused for 15 minutes or boiled for 5 minutes, found both forms effective. Dose was 250 ml (about 8 ounces) four times daily for 7 days in the infusion group and 4 days in the decoction group. Clearance rate was 93 percent and 92 percent respectively. There was a 13 percent recrudescence rate in the infusion group. Recrudescence in the decoction group was not checked.

Early indications are that if the plant is properly prepared and used it can be as effective as artemisinin or its analogues in the treatment of malaria and other blood parasites. It will be especially effective if combined with other plants described in this chapter, especially sida and cryptolepis.

Each tree, each shrub, and herb, down even to the grasses and mosses, agreed to furnish a remedy for some one of the diseases [of humankind] and each said: “I shall appear to help man whenever he calls upon me in his need.”

—
The oral teachings of the Cherokee Nation

Localized nonsystemic antibacterial herbs
do not easily cross the GI tract membrane and concentrate in the bloodstream. They are almost always limited to the GI tract itself, the skin, or certain organs of the body. In the latter instance, it is because those constituents that do make it through the intestinal membrane are eliminated from the body through a particular organ (e.g., garlic through the lungs, juniper berry through the kidneys).

The localized antibacterials need to be used with that in mind; they generally do not act as systemics, even if they are being sold as if they do. Nevertheless, they can be exceptionally potent in the treatment of resistant disease organisms if used properly. Here are four of the best of them.

For the purposes of this book, most berberine-containing plants can be used as analogues for each other in the treatment of resistant bacterial and fungal infections of the GI tract and skin. I prefer the use of invasive species, however, primarily because they tend to be easily found in the wild, are ubiquitous around the globe, and can be harvested with abandon. They are free to those who know them and harvesting them does not create the ecological problems that wildcrafting and large agricultural production of plants such as goldenseal and coptis do.

Berberine-containing plants grow nearly every place on Earth.
Phellodendron amurense
,
Hydrastis canadensis
,
Mahonia aquifolium
,
Berberis vulgaris
, and
Coptis chinensis
are only a few of the major species used medicinally.

However, given their prolific natures, I believe that if you are wild-crafting, the
only
genera that should be used as berberine antibacterials are (in the following order)
Phellodendron
,
Berberis
, and
Mahonia.

If you are buying, look for
Hydrastis
,
Tinospora
,
Coptis
, and
Corydalis
, which are established agricultural crops. The latter two genera are major agricultural products in China and are thus sustainable in a nonwildcrafted sense.
Hydrastis
is being grown in the United States, and it is possible to buy organically grown roots. If you do decide to use any of these species, make sure you are getting commercially grown and not wildcrafted plants.

Personally, I prefer the wildcrafted species. In my opinion they are the strongest—domesticated plants have a tendency to get a bit wimpy over time—and I particularly like the idea of using invasive species for invasive diseases. I think it particularly interesting that
Phellodendron
and
Berberis
species are invasive in the same bioregion in which goldenseal was once prevalent. It points up the rather neglected understanding that plants and their constituents perform specific functions in the eco-ranges in which they grow. The loss of a particular medicinal species always leads to ecosystem degradation
and weakness. But then, the planet has a long history of engaging in correctives to such damage, invasives being just one of them.

Phellodendron amurense
is invasive, especially in the eastern United States, and I believe that it should be the main species used if it is at all available. The plant is a large tree that grows quickly, producing huge amounts of berberine and other alkaloids and synergistic constituents in its inner bark. Branches can be harvested to supply large quantities of medicinal herb with little or no damage to the tree. You can get several years' supply in a short afternoon.