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THUJA

















Other Common Names: Arbor-vitae, tree of life, white cedar (American)
Botanical Name: Thuja occidentalis
Family: Cupressaceae
Plant Part Used: Leaf


PRESCRIBING INFORMATION





































Actions Antimicrobial, depurative, antiviral, antifungal
Potential Indications
Based on appropriate evaluation of the patient, practitioners should consider prescribing Thuja in formulations in the context of:

• Infections from wart viruses, oral and topical use (5,7)

• Treating and preventing nonspecific URTIs, in combination with Echinacea spp. root and Baptisia (2)

• Sinusitis, in combination with Echinacea spp. root and Baptisia (3)

• Topical application for wart infection of the foot (2)

• Topical application for fungal infections of the skin (5)
Contraindications Pregnancy1 and lactation (resulting from the presence of the potentially toxic component thujone in the essential oil of Thuja leaf).
Warnings and Precautions
Thuja should not be taken in high doses over a prolonged period.

Caution is advised in epilepsy because of the thujone content in the essential oil.2
Interactions None known.
Use in Pregnancy and Lactation Contraindicated in pregnancy and lactation.
Side Effects None expected if taken within the recommended dose range.
  High doses of thujone (obtained from ingesting the essential oil) have caused convulsions and neurotoxicity in animals and humans.2 High doses of Thuja may cause headaches attributed to the thujone content. The addictive syndrome known as absinthism (from the liqueur absinthe) has been attributed to the toxic effects of thujone.
Dosage Dose per day* Dose per week*
  1.5-3.0 ml of 1:5 tincture 10-20 ml of 1:5 tincture

* This dose range is extrapolated from the British Herbal Pharmacopoeia 1983 and the author’s education and experience.



SUPPORTING INFORMATION














Traditional Prescribing
Traditional Western herbal medicine uses include:

• Bronchial catarrh, bronchitis with cardiac weakness, intermittent fever1

• Warts (oral and topical use)1

• Enuresis, cystitis,1 urinary incontinence, bedwetting, urethritis3

• Psoriasis, rheumatism1

• Amenorrhea, uterine carcinoma1

• Enlarged prostate3

• Disorders of the blood and glands3

• To counter the ill effects of smallpox vaccination1

• Topically for wounds, skin ulcers, bedsores, fungal infections of the skin, carcinomatous ulcerations, trachoma, rheumatism, leukorrhea; to stop hemorrhage caused by uterine tumor3

Native Americans used Thuja for a wide variety of reasons:as a remedy for cough and headache, as a diaphoretic and to treat intermittent fevers, as a blood purifier, and to flavor other medicines. A poultice of Thuja leaves was used for swollen hands and feet and for heart pain. Thuja was official in the USP from 1882 to 1894 and the NF from 1942 to 1950. Thuja was used as a stimulant to heart and uterine muscle and as a stimulant, irritant, and antiseptic.4
Pharmacologic Research
An important component of Thuja leaf is the essential oil, which contains monoterpenes (especially terpenic ketones, including thujone) and other terpenes.5

Pharmacologic research conducted using (TPS, a high molecular weight polysaccharide fraction isolated from Thuja, is not listed here. The quantity of polysaccharides present in Thuja preparations containing 50% ethanol or more (such as Thuja tincture) would be negligible.

• Constituents of Thuja have shown anticarcinogenic activity in vitro. The concentration of tumor-promoted ornithine decarboxylase was inhibited.6

• Phagocytosis of erythrocytes by Kupffer cells in vitro was significantly improved by a formulation containing Thuja, Baptisia, Echinacea angustifolia, and E. purpurea roots combined with homeopathic remedies. Single herbal extracts also demonstrated activity, with Thuja extract having a prominent effect on the first phase of phagocytosis.7

• Antiviral activity was observed using Thuja extracts against HSV in vitro. Using highly purified fractions of Thuja, the minimal antiviral dose was lower than 50 g/ml, and the 50% cytotoxic dose was 400 μ g/ml.8 A 70% ethanolic extract of Thuja also inhibited HSV in vitro. Using activity-guided fractionation, the main active component was found to be deoxypodophyllotoxin, a known antiviral agent. Commercial tinctures of Thuja were found to contain approximately 0.3 mg/ml of this component.9 Deoxypodophyllotoxin is also known to be active against the wart virus.

• Thuja essential oil demonstrated fungicidal activity against the ringworm fungi Microsporum audouiniii in vitro.10
Clinical Studies
• Herbal formulations containing Thuja have been used successfully for treating and preventing nonspecific URTI in randomized, double-blind, placebo-controlled trials.11,12 These formulations consisted of Thuja, Baptisia, and Echinacea spp. root or these herbs combined with homeopathic remedies. In trials, the daily dose of herbs was well below the normal therapeutic limit (more similar to a homeopathic protocol).

• A controlled trial found combined use of Thuja, Baptisia, and Echinacea spp. root with the antibiotic doxycycline had better success than doxycycline alone in treating acute sinusitis.13

• Thuja extract applied topically for 3 weeks demonstrated benefit for treating foot warts in a randomized, double-blind, placebo-controlled clinical trial involving children and adults.14


REFERENCES



1 British Herbal Medicine Association’s Scientific Committee. British herbal pharmacopoeia. Bournemouth: BHMA, 1983.


2 Millet Y, et al. Clin Toxicol. 1981;18(12):1485-1498.


3 Felter HW, Lloyd JU. King’s American dispensatory, ed 18. Portland: Eclectic Medical Publications, 1905. rev 3, reprinted 1983


4 Vogel VJ. American Indian medicine. Norman, Okla: University of Oklahoma Press, 1970.


5 Leung AY, Foster S. Encyclopedia of common natural ingredients used in food, drugs and cosmetics, ed 2. New York-Chichester: John Wiley, 1996.


6 Chang LC, et al. J. Nat Prod. 2000;63(9):1235-1238.


7 Vomel T. Arzneim Forsch. 1985;35(9):1437-1439.


8 Beuscher N, Kopanski L. Planta Med. 1986;52:555-556.


9 4th International Congress on Phytotherapy, Munich, September 10-13, 1992.


10 Yadav P, Dubey NK. Indian J Pharm Sci. 1994;56(6):227-231.


11 Barrett B, Vohman M, Calabrese C. J Fam Prac. 1999;48(8):628-635.


12 Henneicke-von Zepelin HH, et al. Curr Med Res Opin. 1999;15(3):214-227.


13 Zimmer M. Therapiewoche. 1985;35:4024-4028.


14 Khan MT, et al. J Eur Acad Dermatol Venereol. 1999;12(suppl 2):S251-S252.





THYME














Botanical Name: Thymus vulgaris
Family: Labiatae
Plant Part Used: Leaf


PRESCRIBING INFORMATION


































Actions Expectorant, spasmolytic, antibacterial, antifungal, antioxidant, rubefacient (topically), antimicrobial
Potential Indications
Based on appropriate evaluation of the patient, practitioners should consider prescribing thyme in formulations in the context of:

• Productive cough (2,5)

• Bronchitis, whooping cough, catarrh of the upper respiratory tract (4,5)

• Stomatitis and halitosis (4)

• Laryngitis, sore throat, fever in the common cold (5)

• Dyspepsia, chronic gastritis, colic, flatulence, diarrhea (5)

• Tonsillitis, as a gargle (5)
Contraindications None known.
Warnings and Precautions None required.
Interactions None known.
Use in Pregnancy and Lactation No adverse effects expected.
Side Effects In a group of 100 patients with leg ulcers,5% responded with a positive reaction to patch testing with thyme oil. Allergic contact dermatitis caused by thymol has been reported for a proprietary antiseptic mouthwash used for treating paronychia. Thyme inhaled as dust can cause occupational asthma, which has been confirmed by inhalation challenges.
Dosage Dose per day* Dose per week*
  2-6 ml of 1:2 liquid extract 15-40 ml of 1:2 liquid extract

* This dose range is extrapolated from the British Pharmaceutical Codex 1949, the British Herbal Pharmacopoeia 1983, and the author’s education and experience.



SUPPORTING INFORMATION














Traditional Prescribing
Traditional Western herbal medicine uses include:

• Dyspepsia, chronic gastritis, colic, flatulence, diarrhea1,2

• Bronchitis, asthma, whooping cough, laryngitis, sore throat, catarrh, fever in the common cold1,2

• Hysteria, dysmenorrhea, bedwetting1,2

• As a stimulating tonic in convalescence after exhausting illness2

• Topically for tonsillitis1
Pharmacologic Research
• Thyme extracts exhibited a spasmolytic effect on isolated smooth muscle and inhibited agents that stimulate smooth muscle. The relaxing effect of bradykinin was potentiated.

• The antibacterial and antifungal activity of thymol is well recognized. Essential oil of thyme demonstrated antimicrobial and fungicidal activity in vitro in several studies.

• Components of thyme oil inhibited the growth of seven standard strains of gram-positive and gram-negative bacteria in vitro. A broad spectrum of activity was observed for thymol and carvacrol against bacteria involved in URTIs. Aqueous and ethanolic extracts of thyme demonstrated significant inhibition of Helicobacter pylori in vitro.

• Thyme extracts have exhibited antioxidant activity in vitro.
Clinical Studies
• Oral treatment with large doses of thymol resolved Kaposi’s sarcoma, dermatomyositis, and progressive scleroderma in separate case studies. The thymol was administered at a dose of 1 to 4 g per day in two cycles of 64 and 169 days, with a 35-day interval with no treatment.

• In conjunction with maintaining a continuous state of dryness, topical thymol was successfully used in treating paronychia and onycholysis.

• In a randomized, double-blind study,60 patients with productive cough received either syrup of thyme or bromhexine for a period of 5 days. No significant difference was observed between the two groups, based on self-reported symptom relief. Both groups made similar gains. A nonstatistically significant improvement was observed in the recovery rate of nonsmokers compared with smokers in both groups.

• Vulval lichen sclerosis in two patients was successfully treated with a cream containing thyme extract. No side effects were reported.

• In Germany, the Commission E supports using thyme to treat symptoms of bronchitis and whooping cough and catarrh of the upper respiratory tract.3

• ESCOP recommends thyme for treating catarrh of the upper respiratory tract, bronchial catarrh, pertussis, stomatitis, and halitosis.4


REFERENCES



The following book was referred to in the compilation of the pharmacologic and clinical informationMills S, Bone K. Principles and Practice of Phytotherapy: Modern Herbal Medicine. Edinburgh: Churchill Livingstone, 2000.


1 British Herbal Medicine Association’s Scientific Committee. British herbal pharmacopoeia. Bournemouth: BHMA, 1983.


2 Felter HW, Lloyd JU. King’s American dispensatory, ed 18. Portland: Eclectic Medical Publications, 1905. rev 3, reprinted 1983


3 Blumenthal M, et al, editors. The complete German Commission E monographs: therapeutic guide to herbal medicines. Austin: American Botanical Council, 1998.


4 Scientific Committee of the European Scientific Cooperative on Phytotherapy [ESCOP]. ESCOP monographs: Thymi herba. Argyle House, Gandy Street, Exeter, Devon, EX4 3LS, United Kingdom: European Scientific Cooperative on Phytotherapy, ESCOP Secretariat, March 1996.

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