Herbal therapies are an important aspect of Ayurvedic treatments. Among these is Commiphora mukul, also known as guggal, gumguggal, salai tree, or Indian bedellium.

Guggal is a spiny shrub or small tree with many branches, usually growing two or three meters high, and found in the arid, rocky tracts of Rajasthan, Gujrat and Karnatka in India. A healthy tree yields 250 - 500 grams of resin in one season, and guggal plants typically begin yielding resin after five years. The trees are tapped for resin from November through January, and collection continues until May or June through a nick on the bark of the tree.

Ayurvedic literature is full of praises for guggal and its divine actions, from healing bone fractures and inflammations to treating cardiovascular disease, obesity and lipid disorders. It has carminative, antispasmodic, diaphoretic, antisuppurative, emmenagogue and aphrodisiac qualities. In Tibetan medicine, the plant is used for skin diseases, anemia, edema, salivation and heaviness of stomach. Guggal is used for ulcers, tonsillitis, sore throat, hay fever, nasal catarrh, laryngitis and bronchitis. Gum from the guggal plant is used in the treatment of rheumatism, neurological disorders, obesity, syphilis, urinary disorders and thyroid conditions.

Guggal has also been proven helpful for regulating cholesterol levels. The plant’s lipid lowering properties have been noted among practitioners of Ayurvedic medicine, and modern scientific research is validating these observations. Cholesterol disorders plague millions of Americans and can lead to two of the nation’s primary life threatening illnesses which are heart disease and stroke. Unfortunately, the drugs most commonly used to treat cholesterol disorders often produce unpleasant side effects, including liver damage, cancer, and gallstones. Guggal works to balance conditions of both low and high cholesterol whether brought on by diet, lack of exercise, chronic stress, or genetic predilection. It does not create any of the harmful side effects associated with drugs commonly used for cholesterol disorders.

The National Chemical Laboratory, Pune, India, in collaboration with the Central Drug Research Institute of India, began a detailed chemical study of the hypocholesterolemic / hypolipidemic activity of guggal. The ethyl acetate soluble portion of guggal was found to possess hypolipidemic and anti-inflammatory properties. The ethyl acetate insoluble portion was found to be toxic. Further, acid, base and neutral portions of ethyl-acetate-soluble guggal were separated. The neutral portion is responsible for the hypocholesterolemic activity, while the acid portion showed anti-inflammatory activity.

Guggal has a complex structure made up of various compounds such as lignans, lipids, diterpenoids and steroids. Ten steroids have been isolated from the resin, among these, Z-guggalsterone and E-guggalsterone have been found to have hypolipidemic effects. The other components of the ethyl acetate extract exert a synergistic activity.

Pharmacological and Clinical Studies

Scientists have been studying the hypolipidemic activity of guggal for over 20 years. It began with animal trials in the late 1960’s, and because of it’s success, quickly progressed to human clinical studies. Guggal proved extremely effective in regulating cholesterol, triglycerides, and phospholipids in both types of research. Extracts of guggal have been shown to lower the serum cholesterol level in chicks, and have shown similar effects in rabbits, rats and domestic pigs.

Another study performed in India in the late 1970’s researched the long-term effects of lipid regulating substances on humans. The two substances compared were clofibrate (Atromid-S), an effective and frequently used hypolipidemic drug, and an ether extract of guggal resin. The guggal extract (1.5 grams per day) was taken orally by 41 of 51 subjects suffering from elevated cholesterol trigycerides. The remaining 10 took clofibrate (2.0 grams per day). Cholesterol and triglyceride levels fell significantly, progressively, and equally in both groups. However, the guggal extract was gentler on the body as a whole, producing only mild diarrhea in five of the subjects. No additional side effects and no biochemical abnormalities in the guggal cases were noted. The clinical profiles of the subjects in this study were varied. Some subjects were asymptomatic while others were experiencing acute discomfort as a result of illnesses such as diabetes mellitus, vascular disease and gout. In fact six were suffering from acute cases of skin xanthomatosis; three of these were placed in the guggal group and three in the clofibrate group. The three treated with guggal showed complete regression of skin lesions after 40 weeks, while only one person taking clofibrate experienced such regression. The other two taking clofibrate remained symptomatic during the course of the study.

In a 1986 study, an ethyl acetate guggal extract showed similar benefits to those highlighted in the study above. In this particular trial, the guggal extract compared favorably with other hypolipidmic drugs, significantly lowering serum cholesterol and triglyceride levels in 78.9 percent of test subjects. And, it produced no noticeable side effects - not even mild diarrhea.

Another study of guggal found that serum cholesterol levels were lowered an average of 17.5 percent and 30.3 percent for triglycerides.

At our Ayurvedic and Naturopathic Medical Clinic in Bellevue, Washington, hundreds of patients having high cholesterol levels have been treated with guggal. One patient, a 49 year-old man, came to the clinic with a cholesterol level of 277, and a triglyceride level of 178. After only five months of treatment with guggal, in combination with other Ayurvedic herbs prescribed, his cholesterol level fell to 188 and triglycerides to 96.

A 50 year-old female patient with a cholesterol level of 418, and a triglyceride level of 688, began taking guggal, in conjunction with other herbs and modifications to her diet and daily routine. Within three months her cholesterol dropped to 167 and triglycerides to 322. This patient had been involved for five years in a lipid research project at the University of Washington before coming to our clinic. Another patient with a 239 cholesterol level and a 468 triglyceride level, again after taking guggal for only three months, lowered her cholesterol level to 185 and triglycerides to 129. Finally, a patient with a triglyceride level of 2,121 was given guggal, and within three months triglycerides had dropped to 178.

In a study done of 25 patients suffering from hemiplegia - paralysis of one side of the body - 12 of the patients recovered completely after being treated with guggal for three months. Other studies have reported a significant reduction in body weight among animals and humans treated with guggal gum.

However, the effects of guggal on body weight vary, and may be attributed to the variation in the samples of the guggal gum resin used in the studies.

Guggal has been used traditionally in Ayurveda to treat arthritis due to its anti-inflammatory properties. In one study, three compound Ayurvedic preparations with guggal as a main ingredient were tested for anti-inflammatory activity in rats. All three preparations showed a significant anti-inflammatory effect.

Studies have also shown guggal to be effective in countering hypertension and ischemic heart disease. Guggal can be used as a prophylactic to prevent these diseases, as studies of the plant have shown its effectiveness in reducing plaque formation in the arteries.

How does guggal work?

It is believed that the lipid regulating effects of guggal result from it’s thyroid regulating action, and it’s combined effects of inhibiting the biosynthesis of cholesterol's and promoting rapid excretion of cholesterol. Serum lipid levels are known to be reduced by increased levels of circulating thyroid hormones. Z-guggalsterone, a ketosteroid and a component of guggal, is such an agent. The plant is especially useful where T3 (Triiodothyronine) values of the thyroid are low. Guggal’s thyroid stimulating property also explains the traditional use of the plant for thyroid related problems. Ayurvedic medicine for centuries has prescribed guggal because of its healing actions which today’s technologically equipped scientists are only just discovering!

Increased levels of catecholamines, dopamine and beta-hydroxylase found after taking guggal suggest another possible mechanism of lowering lipid levels in the blood. The high affinity binding anion exchange of guggal has also been suggested to contribute to its hypolipidemic activity.

Dosage

Commiphora mukul chemistry: The oleoresin contains 0.37% essential oil containing mainly myrecene, dimyrecene, and polymyrecene. Alcohol extraction gives a soluble resin and an insoluble carbohydrate gum. Solvent extraction, hydrolysis and column chromatography over silica gel of guggul resin identifies a number of compounds - a diterpene hydrocarbon, a diterpene alcohol, Z- guggulsterone, E-guggulsterone, guggulsterol-I, guggulsterol-II and guggul sterol-III. Cholesterol, sesamin and camphorene are also found. The anti-inflammatory and hypolipidemic fractions have been isolated.

Stereochemistry of guggulsterol-1 determined by X-ray analysis as 20R, 22R which was different from that reported earlier (Tetrahedron Lett. 1981,22,4623); quercetin, quercetin-3-O-a-L-arabinoside, quercetin-3-O-b-D-galactoside, quercetin -3-O-a-L-rhamnoside, quercetin-3-O-b-D-glucuronide, ellagic acid and pelargonidin-3,5-di-O-glucoside isolated from flowers (Fitoterapia 1981,52,221); guggulsterone VI and Z-guggulsterone isolated from gum resin along with 20a-hydroxy-4-pregnen-3-one, 20b -hydroxy-4-pregnen-3-one, 16b-hydroxy 4,17 (20z)-pregnadien-3-one and 16a- hydroxy-4-pregnen-3-one (Tetrahedron Lett. 1981,4623; Tetrahedron 1982,38,2949); linoleic, oleic, stearic and palmitic acids, sitosterol, stigmasterol, cholesterol, campesterol and a-spinasterol identified in seed oil (Indian Drugs 1982,19,339); mukulol sythesized (Tetrahedron Lett. 1983, 24, 3485.

Action: Thyroid stimulant, fungicidal, demulcent, aperient, alterative, stomachic, bitter, immune system stimulant, diaphoretic, stimulating expectorant, diuretic, carminative, antispasmodic and emmenagogue. It has no action on the unbroken skin, but on the abraised skin and on mucous membranes, it acts as an astringent and antiseptic. Two main areas of investigation have been guggul’s Hypolipidemic action and anti-inflammatory effect. Purified guggulu steroid mixture at 0.2 mM completely inhibited ADP-andrenaline- or serotonin-induced platelet aggregation (planta Med. 1979, 37, 367). The aqueous extract of the resin C. mukul significantly inhibited both the maximal edema response and the total edema response during 6 hours of carrageenan-induced rat paw edema⁷. Oral administration of ethylacetate extract of C.mukul in albino rats significantly prevented rise in serum cholesterol and serum triglyceride level, caused by atherogenic diet. C.mukul was also found to confer significant protection against atherogenic diet induced atherosclerosis. The essential oil of C.mukul was tested for efficacy against Aspergillus flavus, A. fumigatus, A. sulphureus, Mucor fragilis and Rhizopus stolonifer. C.mukul was fungistatic or fungicidal to one or other of the molds, depending on the concentrations.

Clinical uses: Guggul is used to treat hypercholesterolemia, inflammation, edema, pyorrhoea, chronic tonsillitis, chronic dyspepsia, colitis, catarrh of the bowels, tubercular ulceration, fever, anemia, neurasthenia, debility, laryngitis, bronchitis, pneumonia, whoopping cough, cystitis, gonorrhea, rheumatism, nervous diseases, urinary disorders, atherosclerosis, hemiplegia, diabetes, hypertension, ischemic heart disease, obesity, arthritis and skin diseases.

Safety: Purified Guggul may be taken for a long time without ill effects. Unpurified guggul sometimes produces an erythematous rash and rarely symptoms of kidney irritation may appear, but these rapidly disappear when this is not taken.

REFERENCES

1. Raghunathan, K. and R. Mittra: Pharmacognosy of Indigenous Drugs. Central Council for Research in Ayurveda & Siddha, New Delhi (1982)

2. Bose, S. and K. C. Gupta: Ind. J. Chem. 2:57 (1964).

3. Bose, S. and K. C. Gupta: Ind. J. Chem. 2:156 (1964).

4. Patil, N.D. et al.: Tetrahedron *:2341 (1972)

5. Satyavati, G.V.: Effect of an indigenous drug on disorders of lipid metabolism with special reference to atherosclerosis and obesity. Thesis submitted for the degree of Doctor of Ayurvedic Medicine, BHU, Varanasi (1968).

6. Ram P. Rastogi and B.N. Mehrotra: Compendium of Indian Medicinal Plants, Vol. 3. Central Drug Research Institute, Lunow, India.

7. Duwiejua M, Zeitlin IJ, Waterman PG, Chapman J, Mhango GJ, Provan GJ.: Anti-inflammatory activity of resins from some species of the plant family Burseraceae. Planta Med 1993, Feb;59 (1):12-16.

8. Lata S, Saxena KK, Bhasin V, Saxena RS, Kumar A, Srivastava VK.: Beneficial effects of Allium sativum, Allium cepa and Commiphora mukul on experimental hyperlipidemia and atherosclerosis — a comparative evaluation. Department of Pharmacology, L.L.R.M. Medical College, Meerut, Uttar Pradesh.

What kind of nutrition should we have during the winter. Winter is considered as a whole good for health. The digestive power of human beings is usually stronger during the winter and so they are able to digest more heavy foods. Traditionally heavy foods have been utilized all over the world during winter. People will eat more nuts and seeds, oily food, meat and fish, all of which are considered to be heavier foods. Winter is the season of Vata so there will be a general tendency towards aches and pains. Because winter is also a Kapha season people will be prone to diseases like colds, flues, asthma, pneumonia, arthritic pains, knee and joint pains Utilization of more nuts and seeds, flaxseed oil, fish oil, olive oil, sesame oil, in a balanced ratio will be very helpful for people with these conditions. These oils (especially sesame oil) are a very rich source of essential fatty acids, and vitamin E. Nuts and seeds are also a great source of essential fatty acids. If you don’t eat these heavy foods, vata will get out of balance and you will begin feeling aches and pains. So foods which are oily, sour, salty, like meat broth, fish broth and aquatic fowl like ducks are better for you during this season. Honey is also recommended during the winter. During the winter, excessive use of foods which are pungent, bitter and astringent, are not considered good. You should also avoid cold food and cold drinks because they also increase Vata and Kapha in the body. And again as I have mentioned in previous newsletters the excessive use of wine is not recommended.

Exercise is very important during the winter because we are consuming more calories and because of our lifestyle during the winter. We have heated houses and heated cars, so we are not losing as much fat as we are consuming, but we continue the habit of consuming more calories by nature. Somehow we end up storing fat and not burning it during the winter. So most people will gain weight during the winter because the days are shorter, there is not much light and people don’t get out to exercise because of the cold weather. I highly recommend that everybody exercise during the winter.

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2. Balance the carbohydrates, protiens and fats in your diet.

3. Eat when you are hungry. Give yourself time for thorough digestion (2-4 hours depending upon meal).

4. Take a 30 minute morning and evening walk.

5. Add essential fatty acids to your diet.

6. Cut down on saturated fats in your diet.

7. Eat your largest meal at lunchtime when your di gestion is strongest.     Dinners should be kept light.

8.     If your serum cholesterol is elevated try Guggal Extra Strength and Triphla.

9. Exercise for 15 - 30 minutes a day on a regular basis.

Crohn’s disease has been reported with increasing frequency, especially in western populations with southern European or Anglo-Saxon ethnic derivation. The disease occurs equally in both sexes, and is more common among Jews and shows a familial tendency that frequently overlaps with the occurrence of ulcerative colitis. Most cases develop before the age of 40 and can occur in the early twenties. In Crohn’s disease inflammatory lesions involve all layers of the intestinal wall which become greatly thickened and effects the layers of the intestine, sometimes causing extensive fibrosis. The ulceration's that develop on the mucosa are described as cobblestone in appearance. Inflammation, deep ulceration, edema, and fibrosis are usually responsible for obstructions, fistulas, absesses, and other local complications. Crohn’s disease is usually associated with abdominal pain, fever, anorexia, weight loss, and a fullness in the right lower quadrant. At times people will be seen with abdominal pain simulating acute apendicitis.

Common patterns seen in Crohn’s disease are:

#1 Inflammation usually characterized by right lower abdominal pain, tenderness, usually mimicking appendicitis.

#2 Intestinal obstruction.

#3 Malnutrition

#4 Abdominal fistulas, and absesses usually developing late in the disease

Complications from Crohn's disease can include arthritis, episcleritis, aphthous stomatitis, and erythema nodosum. Crohn’s disease can also be associated with diseases like ankylosing spodylitis, which is a disease of the spine also called bamboo spine or arthritis of the spine, sacroilitis, an inflammation of the sacroiliac joint, uveitis inflammation of the uvea or eye. Other complications can include urinary tract infections caused by fistulization and kidney stones due to excessive uric acid metabolism and reduction in calcium absorption, . Diagnosis of these complications are usually made by doing a barium X-ray or barium enema, fiberoptics colonoscopy may help to confirm the diagnosis, but even then it is difficult to differentiate between ulcerative colitis and Crohn’s disease, especially if the disease is only involving the colon area of the intestine.

Specific treatment is available for Crohn’s disease. Some of the combinations of drugs that have been used include anti-bacterials like sulfasalazine and metronidazole. Long term use of sulfasalazine has been prescribed but this has toxic side effects, metronidazole also has many serious side effects associated with its long term use. Corticosteroid therapy is useful in acute cases of Crohn’s disease, but long term use does not have many benefits. Immunosuppresant drugs are Sometimes used in treating Crohn’s disease but they also have side effects.

In Ayurvedic medicine, Crohn’s disease is looked at as an imbalance of the small intestine and gastrointestinal tract and we are trying to create a balance by changing nutrition , stress reduction, exercise, yoga, and using herbs.

A twenty seven year old female came to the Ayurvedic & Naturopathic Medical clinic with the diagnosis of Crohn’s disease. Although literature does not support Crohn’s disease and gluten intolerance, I put her on a gluten free diet. I have noticed that a lot of people with Crohn’s disease do have an intolerance to gluten, so gluten containing foods especially wheat, rye, barley, may cause problems. This also means that alcoholic beverages like beer, vodka, or whiskey and a treats like ice creams, and chewing gums, that have added gluten are processed from gluten cause problems. The diet I prescribed actually eliminated only wheat and the nightshade family which includes tomatoes, potatoes, bell peppers, and other peppers because the nightshade family stimulates the inflammation process. Basically I believe that the gastrointestinal tract is a very important immunologic area and that it has a thinking immune system which can trigger wrongly in reaction to certain foods and stress factors, which then causes inflammation of the large intestine. This patient was also taught how to meditate using breathing exercises, use yoga stress relief postures to help with stress reduction and to exercise the abdomen so that she could increase the vitality and musculature of her intestine. She was also given a prescription of Ayurvedic herbs which included; Boswelya Plus, Trifal, Livit-2 and Ashwagandha. Boswellia was prescribed because it has wonderful effects on reducing inflammation anywhere. And because in this case the liver was producing toxic materials, Livit-2 was prescribed to help the Liver detoxify. Trifal helps digest food and as a mild laxative helps eliminate toxic materials, and Ashwagandha is a wonderful herb for stress relief. Crohn’s disease patients can also be prescribed Bacopa Monnieri or Bacopa Plus because it helps to tranquilize or make dealing with stress easier. There have been studies done with irritable bowel syndrome where the patient has seen positive results.

As the office manager for the Ayurvedic & Naturopathic Medical Clinic I have an opportunity to meet all of the wonderful people that come here for treatment. An important part of my job is answering questions about the clinic, care, procedures and the herbs we prescribe.

In this small space I will do my best to address the most commonly asked questions as well as some of the interesting ones I am asked. Some of these may include: Is treatment covered by insurance?, Why do I have to take all my herbs at once?, Where is the bathroom?, and Who are those people walking around in oily sheets?

Until next time, feel good!

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Though many advances in cancer chemotherapy have been made which have resulted in the improved quality and lengthened life of pets, with a variety of malignancies there is still a potential risk of toxicosis from these treatments. There is also a concern about drug resistance and the cost factor involved. The number of successfully treated or managed tumors with the use of chemotherapeutic agents, is increasing every single year. Currently some of the cancers successfully treated include leukemia, lymphoma, pulmonary lymphatic granulamatosis, multiple mylomas, among other hematopoietic tumors, mammary neoplasia, canine thyroid carcinoma, squamous cell carcinomas, transmissible venereal tumors, osteosarcoma, and oral malignant melanomas.

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