Urinary Antiseptics and Demulcents

1. Urinary Antiseptics and Demulcents

2. Arctostaphylos Uva Ursi

3. Arctostaphylosuva-ursi

4. Arctostaphylosuvaursi

5. ArctostaphylosUva-Ursi Arctostaphylos, from the Greek, 'arktos (arktos), "bear”, stafulh (staphyle), "grapes" uva-ursi, from the Latin uva, "grape, berry of the vine", ursi, bear; "bear's grape" Uva-Ursi, Kinnikinnick, Crowberry, Foxberry, Mealberry, Mountain Box, Mountain Cranberry , Upland Cranberry.

6. ArctostaphylosUva-Ursi Family: Ericaceae Grows throughout the Western foothills and mountains, from California through Alaska Part used: Leaves Qualities: Dry, astringent, cold

7. ArctostaphylosUva-Ursi Constituents: hydroquinone glycosides (4-15%): arbutin,methylarbutin polypheneols, tannin (increased in older leaves), Flavonoids(quercetin), Acids (ursolic, gallic, ellagic), Allantoin, Volatile oil: lupeol

8. Arctostaphylos Uva-Ursi • Standardized extract; 70 mg arbutin: two 0.7 g tabs BID-TID.; 400-840 hydroquinone derivatives calculated as water-free arbutin. • Tincture: 1:5 tincture: 10-17 ml qd; 1:2 2-4 ml TID • Infusion: 2-3 tsps/ cup boiling water. Drink 1 cup qid. [because the Ericaea leaves are tough, sometimes its helpful to do a modified version, simmering for a couple of minutes.

9. Vaccinium macrocarpon

10. Vaccinium macrocarpon

11. Vacciniummacrocarpon • Common name: Cranberry • Family Ericacea • Part used: Berry, juice of berry • Constituents: hippuric acid, Proanthocyanadins, Vitamin C • Cranberries contain proanthocyanidins (PACs) that can prevent the adhesion of bacteria to the urinary tract wall. The anti-adhesion properties of cranberry may also inhibit the bacteria associated with gum disease and stomach ulcers. • Important note: the mechanism of action is not due to acidification of the urine.

12. “Impact of cranberry on Escherichia coli cellular surface characteristics. “ • “The anti-adhesive effects of cranberry have been attributed to both interactions of its components with the surface of bacterial cells and to inhibition of p-fimbriae expression…Here, we show that the morphology of E. coli is changed when grown in the presence of juice or extract from Vacciniummacrocarpon (cranberry). Gene expression analysis indicates the down regulation of flagellar basal body rod and motor proteins.” Johnson BJ, Lin B, Dinderman MA, Rubin RA, Malanoski AP, Ligler FS. BiochemBiophys Res Commun. 2008 Dec 19;377(3):992-4. Epub 2008 Oct 26.

13. Vacciniummacrocarpon • Medicinal action: Bacteriostatic • Medicinal uses: Acute urinary tract infection • Contraindications: It has no known toxicity, and appears to be safe in pregnancy and lactation.

14. Vacciniummacrocarpon Dosing: • Standardized extract 400-500 mg TID • Tincture (1:4): ½ tsp tid-qid • Non-etandardized encapsulated products vary widely in strength, and relative dose recommendations (usually around 5000 mg qd of fresh cranberry equivalent or 1500 mg qd cranberry juice equivalent).. • Fresh cranberry juice 0.5 L/day. It is important to note that this needs to be pure cranberry juice that is sugar free. .. or is it so important?

15. Chimaphila umbellata

16. Chimaphila umbellata • Common names: Pipsissewa, Prince’s Pine, Winter Green (not the same as Gaultheria procumbens) • Family: Ericaceae • Part used: Herba • Grows locally and throughout the temperate regions. • Constituents: Arbutin, chimaphillin, methyl salycilate, tannins. • Actions: Astringent, antimicrobial (arbutin), tonifying, diuretic • Indications: Acute urinary tract infections

17. Chimaphila umbellata Dosing: • Tincture: 2.5-5 ml BID-QID • Infusion:2-3 tsps/ cup boiling water. Steep 5-10 minutes. Drink 1 cup 3-5x per day

18. (Barosma betulina) Agathosma betulina

19. Agathosma betulina • Common name: Buchu • Family: Rutaceae • Part used: Leaves • Native to South Africa • Volatile oil (2%): diosphenol (=buchu camphor), pulegone, (+) and (-) isopulegone, 8-mercapto-p-menthan-3-one, 8-acetylthiomenthone, piperitoneepoxide (+)-menthone, isomenthone, p-cymol, limonene, terpineol • Flavonoids: rutin, diosmin, hesperidin, quercitin and derivatives • Miscellaneous; B-vitamins, tannin and mucilage.

20. Agathosma betulina • Medicinal Action: Urinary antiseptic, stimulating diuretic, diaphoretic • It also has some nervine action, and can be used when there is anxiety accompanying urinary inflammation. Dosing: • Dried leaf: 3-6 g qd • Tincture (1:2) 1-2 ml BID, (1:5) tincture: 2.5-5 ml BID • Infusion: 1-3 tsp/cup water infused for 10 min, 1 cup TID

21. Agropyron or Elymusrepens

22. Agropyron or Elymus or Elytrigiarepens

23. Agropyron repens • Common name: Quack Grass, Couchgrass • Family: Graminaceae • Distribution: A common pest plant in temperate regions. “Invades” lawns and landscapes Constituents: • Saponins • Carbohydrates (3-8% triticin polysaccharide, 2-3% inositol and mannitol, 10% mucilage) • Volatile oil (agroyprene), fixed oil •  carotene, Minerals (silica, iron, potassium), Silicic acid and silicates

24. Agropyron repens • Medicinal action • A saponin and carbohydrate (mannitol) based diuretic • Demulcent • Antimicrobial • Expectorant

25. Agropyron repens • Decoction: • 2 tsp/cup water. Bring to boil, simmer x 10 min. Drink TID. • Tincture (1:5 25%): 3-6 ml tid • No toxicity or contraindications

26. Zeamays

27. Zea Mays (Maydis stigmata) • Common name: Cornsilk • Family: Graminaceae/Poaceae • Part used: Flower Pistils • Saponins, allantoin, sterols (beta-sitosterol, stigmasterol ), alkaloid (hordenine), vit. C, vit. K, potassium, carbohydrates including mucilage; cryptoxanthin, anthocyanins, plant acids, fixed oil (2%), essential oil (0.1%): carvacrol, terpenes, bitter compounds, polyphenols (12%), potassium salts

28. Zea Mays (Maydis stigmata) • Acute: 2-4 g/day; infused in 1-2 Qt/day or 1 cup every hour [1tsp. = 0.5g] • Best as a cold infusion. • Tincture (1:5 25%): 3-18 ml /day

29. Parietaria judiaca

30. Parietaria judiaca • Family: Urticaceae • Name: Pellitory-of-the-wall • “Pariet” or “pared” means “wall” • Used to be called P. officinalis, and there is still controversy over whether p. judiaca is the same species or slightly different from P. judiaca. • Pollen is highly allergenic and sticky; plant often called “sticky weed”

31. Parietaria judiaca • Diuretic and demulcent • High in flavonoids and potassium • Most useful for inflammatory conditions of the kidney or bladder • Nephritis • Cystitis • Considered a trophorestorative to the kidneys • “Sylibum of the Kidney”

32. Parietaria judiaca

33. Case 1 • 63 year old woman with an extensive history of recurrent cystitis treated using antibiotics. • Had “bladder lift” surgery 5 years ago to correct a malformed urethra and prolapsed uterus. The UTI’s did not stop, and she suffered extensive nerve damage. • She must self-catheterize to void her bladder if it fills past a certain point. She takes prophylactic antibiotics, which affects her digestion and promotes yeast infections. • Also a long history of anti-anxiety, anti-depressant, and sedative medications x 40+ years.

34. At this point she seeks help from a naturopath, since the medical help she has gotten so far has only made things worse over the years. • What can we do for her?

35. Urinary Formula • Arctostaphylos uva ursi 2 parts • Agathosma betulinum 2 parts • Achillea millefolium 1 part • Elymus repens 2 parts • Parietaria judiaca 2 parts • Zea mays 1 part • Infusion – one tablespoon per cup. 4 cups per day. Sweeten with mannose. • Also drink 8 oz. cranberry or blueberry juice per day.

36. Other treatment considerations • Exercises for strengthening the pelvic floor muscles. • Gradually work toward discontinuing the anxiety/depression/sleep meds • Use diet and supplementation to support healthy brain chemistry • Regular counseling • Probiotics, bitters, astringents to restore digestive health • Vaginal suppositories to restore normal pH and flora • Boric acid, Hydrastis, vitamins A & E, Acidophillus

37. REMEMBER… • Dr. King’s birthday next week… No class!!