Botanical Medicine: Urinary and Male Reproductive Systems

• The presentation discusses botanical medicine for urinary and male reproductive systems, specifically urinary tract antimicrobials and antilithics.

Differentiating "Male Herbs"

• Reminder to differentiate "male herbs" based on their properties: 5a reductase inhibitor, aromatase inhibitor, decreases prolactin (PRL), decreases estrogen, A-1 adrenergic blocker, decreases fibroblasts/proliferation, contains beta-sitosterol, and other notable effects.

Objectives

• Understand the uses of botanical medicine when supporting urinary/kidney conditions.
• Describe and differentiate herbs commonly used for reproductive and urinary/kidney conditions.
• Identify the primary actions of each herb and the primary conditions each herb treats.
• Distinguish key constituents for each herb, their mechanisms of action (MOA), and safety.
• Understand interactions, contraindications, side effects, and toxicity for each herb.
• Differentiate between herbs to select appropriate and effective treatments for conditions.

Urinary Tract/Kidneys

• Addressing the urinary tract has multiple applications outside the system itself.
• Applications include supporting kidney health, managing rheumatism, gout, hypertension (diuretic action), diabetes/metabolic syndrome, and addressing "male" and "female" conditions.

Urinary Tract Scope of Practice

• Botanicals are used in treatment of UTIs and functional disturbances of micturition.
• Botanicals are used in management of interstitial cystitis, urinary stones, edema, and mild to moderate kidney disease.
• Exercise extreme caution when using botanicals for renal failure, urinary obstruction, and severe glomerulonephritis.

Antimicrobials

• Antimicrobials are used for urinary tract and other infections.
• Considerations for use include the need to target specific issues, diagnose the UTI, address necessary actions for treatment, and consider other supportive treatments.

Arctostaphylos Uva-ursi

• Part used: Leaf.
• Contains: Hydroquinone derivatives (arbutin), polyphenols, tannins, flavonoids, and resins.
• Main active constituent: Arbutin.
• In the GI tract, arbutin is converted into a sugar molecule and hydroquinone.
• Hydroquinone converts in the liver where glucuronide is added to make it water soluble, becoming hydroquinone glucuronide.
• Hydroquinone glucuronide passes into the kidneys; hydroquinone acts as an antimicrobial when urine is alkaline.
• Alkaline urine pH adjust by adding 1-2 tsp of baking soda to water.
• Hydroquinone/arbutin is used as a skin lightener for melasma and freckles by inhibiting tyrosine, thus inhibiting melanin production.
• It has antimicrobial properties.
• Should be short-term to address acute conditions; if used longer than 1 week, take breaks.
• Used for acute and chronic UTIs, urethritis, and prostatitis.
• Can be combined with demulcent and antispasmodic herbs.
• Antimicrobial in GI: Used for dysbiosis and dysentery.
• Sitz bath for leucorrhea and vaginitis.
• it acts as an astringent.
• Contraindicated during pregnancy since its uterine stimulating effects, and arbutin is associated with potential fetal development risks.
• Discouraged: Lactation because arbutin may transfer in breast milk.
• Not recommended for children under 12.
• Not for long-term use due to tannins.
• It can lead to gastric irritation and, in large doses, can cause nausea.
• You are to limit use to 10 days and then take a break.
• Exercise Caution in constipation, iron deficiency, and malnutrition as tannins can exacerbate these conditions or bind nutrients, decreasing absorption.
• May cause green tinge in urine with high amounts.
• Cranberry may be combined, which doesn't dramatically effect urine pH.
• Benefit from cold infusion because it will result in more arbutin and less tannins being extracted, causing less irritation.
• Interactions: separated with thiamine, metal ion supplements, alkaloid-containing medications and herbs.

Local plant information

• Manzanita - Arctostaphylos spp belongs to the same family.
• Manzanita will not feature on these tests or NPLEX.

Juniperus Communis

• Fruit (typically referred to as the berry, but is technically the female cone, which is fleshy)
• Contains volatile oils (0.5-2%), resins, bitter glycoside, tannins (condensed), and flavonoids.
• Acts as antimicrobial with an affinity for urinary tract.
• Indicated for acute/chronic UTI, urethritis, and prostatitis.
• Diuretic, carminative with bitter taste, and a counter irritant when used topically for rheumatic joints or myalgia.
• Contraindications: First trimester pregnancy.
• Due to presence of volatile oils, short term use only during pregnancy.
• The effect on lactation lacks data.
• Limit use is short term: 4 weeks at a time max then take a break.
• Considered irritating to the kidneys. The fresh berries are considered more irritating than dried.
• Other species of Juniper (J. sabina) contain a potentially toxic monoterpenoid which may have caused side effects and kidney inflammation.
• Exercise caution with kidney inflammation.
• Used an in infusion, tincture (typically combined), and topically & burned for purification

Antilithics/Lithotrophics

• Help dissolve and eliminate urinary, kidney, and gall bladder calculi.
• Increased excretion of uric acids and/or oxalates.
• Moderate solvent action and alkalizing effect on urinary tract.
• Diuretics also tend to decrease urinary gravel.

Nephrolithiasis

• Nephrolithiasis involves symptoms.
• Treatment targets symptom relief and stone removal or dissolution.
• Botanical actions can aid in achieving these goals.

Hydrangea Arborescens

• Root
• Contains cyanogenic glycoside (hydrangein), saponins, and flavonoids.
• Traditionally used to treat blood in the urine, kidney stone passage, and urinary tract infections.
• It is a Diuretic: Effective for acute or chronic inflamed or enlarged prostate, urethritis, edema, urinary gravel, or kidney stones.
• Aids elimination of urinary crystals and reduces the tendency to form calculi.
• Analgesic: Alleviates deep-seated pain in the kidneys associated with stone passage or nephritis.
• Contraindications: Pregnancy and lactation.
• Ingestion of the fresh plant may result in gastroenteritis.
• Typically combined and used in tincture or decoction.

Eupatorium Purpureum

• Root
• Contains pyrrolizidine alkaloids, volatile oils, flavonoids, and resin.
• Unsaturated pyrrolizidine alkaloids undergo transformation via cytochrome P450, forming toxic intermediates that can damage proteins lining blood vessels.
• Damage often focuses on the liver, causing irreversible fibrosis around liver venules (hepatic veno-occlusive disease).
• These alkaloids likely cross the placenta, limiting internal use.
• Functions as a diuretic
• Use with inflammation modulators to decrease the urgency and sense of obstruction in BPH, chronic prostatitis, and cystitis.
• Decreases the tension in the urinary tract that contributes to pain.
• Primarily treats and prevents kidney stones/gravel.
• Treats cystitis, urethritis, and prostatitis.
• Contraindications: Pregnancy, lactation, liver disease due to pyrrolizidine alkaloids.
• Limit use to short-term (10 days).
• Typically combined with other herbs.

Inflammation Modulators

• Useful for MOST conditions.
• GU: Helpful in UTI, interstitial cystitis (aka bladder pain syndrome), BPH, prostatitis, epididymitis, any "itis," endometriosis, and pelvic congestion syndrome.
• Supportive for GUSM, addressing urinary incontinence and vaginal dryness/dyspareunia.

Apium Graveolens

• The Fruit (often referred to as the seed, but it is the fruit)
• Volatile oils (1.5-3%), flavonoids (luteolin), furanocoumarins.
• Luteolin reduces inflammation, reducing COX-2 in inflammatory responses and suppressed inflammatory mediator release by blocking NF-kappaB.
• The celery stalks (petioles) contain 3-n-butylphtalide which lowers blood pressure by relaxing smooth muscles in the blood vessel walls leading to vasodilation and lowering resistance.
• functions as a diuretic
• Used in combination with other herbs to treat cystitis and urinary gravel via increased urinary tract flushing.
• Aids kidney stone passage and reduces edema.
• Used adjunctively with other herbs to lower blood pressure
• Eating celery stalks(technically the petioles) can also lower blood pressure. Multiple celery stalks must be eaten per day
• It is an inflammation modulator
• treat gout and arthritis/rheumatic conditions
• Used to increase uric acid excretion.
• carminative/spasmolytic.
• Contraindications: Pregnancy; possible emmenagogue
• Lactation category CC
• Possible photosensitization due to furanocoumarins
• Two case studies reporting decreased thyroxine with simultaneous ingestion of Apium seed tablets
• Kidney inflammation due to possible irritation of the EO on kidney epithelium
• Used as tincture or infusion
• For carminative action, often used as an in infusion after meals

Solidago Sp

• Flowers
• Contains: Flavonoids, triterpene saponins, phenol glycosides, polysaccharides, and essential oils.
• Affinity for the urinary and respiratory tracts.
• Acts as a diuretic, addressing urinary inflammation or gravel; take prevent kidney stone recurrence.
• Functions as an Inflammation modulator: Servesas An adjuvant for lower urinary tract infections or inflammation (cystitis, urethritis, prostatitis).
• Great mouth and throat rinse/gargle for inflammation & Arthritis/rheumatic joints
• Decreases upper respiratory congestion and inflammation: allergic rhinitis, sinusitis, URI, postnasal drip, bronchitis with profuse expectoration due to an anit-catarrhal
• Is an astringent
• It's a Diaphoretic (stimulating/heating).
• It acts as a spasmolytic
• Muscle spasm, injury to reduce tension in the muscle and modulate inflammation; topical is best for this use
• Pregnancy category B2
• Lactation category C
• Caution: Allergy to Asteraceae family
• Take hot for action as a diaphoretic
• Pleasant as an infusion or tincture; typically combined

Upcoming Schedule

• Complete learning activity.
• Focus on genitourinary herbs.
• Herbs to discuss, Equisetum arvense, Zea mays, Taraxacum officinalis
• Review physiology, actions, and formulation for reproductive, urinary, and kidney related conditions.
• The last case (nocturia) is due the Saturday of week 10.
• The third exam, covering male reproductive and urinary herbs, will occur in 2 weeks.