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Indoor Air Pollution

indoor air pollutionIndoor air pollution is one of the most overlooked threats to human health. Households in developing countries might be the hardest hit. Because children spend almost eighty percent of their time indoors, they are the most likely victims. In the past several years it has been determined that conditions ranging from asthma, headaches and fatigue to allergic reactions, hormone imbalances and central nervous damage may be attributed to indoor air quality—or, rather, the lack of it. Most of us realize that outdoor air quality can affect health, but few pay attention to the indoor air…unless it smells bad.

In a paper supported by the University of Medicine and Dentistry of New Jersey and printed in the British Medical Bulletin in the early 2000’s, Junfeng (Jim) Zhang and Kirk Smith allowed that the ubiquitous character of indoor air pollution “…may contribute to increasing prevalence of asthma, autism, childhood cancer, medically unexplained symptoms, and perhaps other illnesses.”   Because the sources of indoor pollution are not expected to abate in the near future, particularly those associated with tobacco use, we can expect to voice concerns for a long time. The authors add that “…risks associated with solid fuel combustion coincide with risk associated with modern buildings.”

COMMENTARY
It is absurd that indoor air quality should be so poor that it causes sickness and disease, yet that appears to be more the rule than the exception in modern times.  Nobody would think of running a tractor-trailer or a tour bus in the living room, but the pollution effect is the same.  Most of us are unaware of the problem because a single major source of indoor pollution can’t be fingered. Despite this unrecognized threat, indoor pollution is twice as bad as outdoor, according to studies performed by the Bloomberg School of Public Health at Johns Hopkins.  Others put the rate at five times. There are so many sources of indoor pollution that have become part of our daily lives that we never question them. Have you thought about the unpronounceable ingredients in your cleaning products and other household chemicals, like the pesticides you use in the yard? How about your cosmetics and the smelly things you plug into the wall to hide other smelly things?  Got new carpet or upholstery? Oh, yeah, there are more, such as the aroma of hot tar being applied to the new roof at your children’s school…while school’s in session. The activity may be outdoors, but the sickening smell is certainly indoors.

The influx of biological pollutants is hard to manage.  Molds, bacteria, viruses, animal dander, skin particles (yes, even human), pollen and dust mites are everywhere.  You can see airborne particles in that beam of sunshine coming through the window, but you can’t identify any of them.  Some can breed in the stagnant water that sits in your humidifier, or where water has collected in your ceiling tiles, insulation or carpet.  These things can cause fever, chills, cough, and chest tightness, among other symptoms.  Even when we do what we think is good for the family, we may do the opposite.  Burning the woodstove or fireplace might save money on the heating bill (though the fireplace is suspect), but how about the junk it puts into the air?  You can’t win, eh?

In our attempts to conserve energy, we have sealed our houses so tightly that nothing can get in and less can get out.  Once we change the air pressure dynamics of our houses, we have allowed intruders to enter.  Radon and soil gases are most common, and they creep through the cellar floor.  Mechanical ventilation can help to get the junk out and bring at least some fresher air in.  Not only does insulation contribute to the tightness of our homes, but also it brings problems of its own in the form of irritating chemicals.

Increasing ventilation is one of the easiest steps to improving indoor air quality.  Even in the dead of winter it’s a good idea to open the front and back doors simultaneously once a day to let fresh cold air in and the stale reheated air out.  Pathogens grow in an environment that is warm, dark and damp.  Your hot-air heater is a prime breeding ground for colds and the like.  The American Lung Association and the Mayo Clinic have recognized air filters as being sufficiently effective to allay at least some of the problem.   Using a vacuum with a HEPA filter is another prudent intervention.

Concerning household cleaners, we all know that anything natural costs more than anything man-made, and that mindset is hard to figure out.  Why do we have to pay for things that are left out?  In the mean time, note that vinegar-water concoctions are just as good as many commercial products at cleaning our homes—even the commode.  Who cares if it smells like salad?

But what might just be the best air cleaner on the planet is a collection of house plants.  Formaldehyde is a major contaminant of indoor air, originating from particle board, carpets, window coverings, paper products, tobacco smoke, and other sources.  These can contribute to what has been called “sick building syndrome.”  The use of green plants to clean indoor air has been known for years.  This phytoremediation has been studied with great intensity in a few laboratories across the globe, where it was learned that ferns have the greatest capability of absorbing toxins.  (Kim, Kays. 2010)  As is the case with many endeavors, there is a hierarchy of plants that does the job.  After the ferns, the common spider plant (Chlorophytum comosum) was found best at removing gaseous pollutants, including formaldehyde.  Way back in 1984 NASA released information about how good the spider plant is at swallowing up indoor air pollution.  The heartleaf philodendron partners well with Chlorophytum.  Dr. Bill Wolverton, retired from NASA, has a list (http://www.sti.nasa.gov/tto/Spinoff2007/ps_3.html).  Areca and lady palms, Boston fern, golden pothos and the dracaenas are at the top.  Plants with fuzzy leaves are best at removing particulates from smoke and grease, and some are even maintenance-free (almost), including the aloes, cacti, and the aforementioned spider plants, pothos and dracaenas, the last sometimes called the corn plant.

For more information, try these resources:

Indoor Air Pollution Increases Asthma Symptoms (Johns Hopkins Bloomberg School of Public Health)
http://www.jhsph.edu/publichealthnews/press_releases/2009/breysse_indoor_asthma.html

Pollution at Home Often Lurks Unrecognized (12/26/2008, Reuters Health) by Amy Norton
http://www.reuters.com/article/2008/12/26/us-pollution-home-idUSTRE4BP1ZL20081226

Air Purifiers and Air Filters Can Help the Health of Allergy and Asthmas Sufferers (S. A. Smith)
http://ambafrance-do.org/alternative/11888.php

Indoor Air Pollution Fact Sheet (08/1999, American Lung Association)
http://www.lungusa.org/healthy-air/home/healthy-air-at-home/

An Introduction to Indoor Air Quality (Environmental Protection Agency)
http://www.epa.gov/iaq/ia-intro.html

References

Br Med Bull (2003) 68 (1): 209-225.
Indoor air pollution: a global health concern
Junfeng (Jim) Zhang and Kirk R Smith

Environmental and Occupational Health Sciences Institute & School of Public Health, University of Medicine and Dentistry of New Jersey, NJ

Indoor air pollution is ubiquitous, and takes many forms, ranging from smoke emitted from solid fuel combustion, especially in households in developing countries, to complex mixtures of volatile and semi-volatile organic compounds present in modern buildings. This paper reviews sources of, and health risks associated with, various indoor chemical pollutants, from a historical and global perspective. Health effects are presented for individual compounds or pollutant mixtures based on real-world exposure situations. Health risks from indoor air pollution are likely to be greatest in cities in developing countries, especially where risks associated with solid fuel combustion coincide with risk associated with modern buildings. Everyday exposure to multiple chemicals, most of which are present indoors, may contribute to increasing prevalence of asthma, autism, childhood cancer, medically unexplained symptoms, and perhaps other illnesses. Given that tobacco consumption and synthetic chemical usage will not be declining at least in the near future, concerns about indoor air pollution may be expected to remain.

SUPPORTING ABSTRACTS
Nippon Eiseigaku Zasshi. 2009 May;64(3):683-8.
[Indoor air pollution of volatile organic compounds: indoor/outdoor concentrations, sources and exposures]. [Article in Japanese]
Chikara H, Iwamoto S, Yoshimura T.
Fukuoka Institute of Health and Environmental Sciences, Mukaizano, Dazaifu, Fukuoka 818-0135, Japan. [email protected]

In this review, we discussed about volatile organic compounds (VOC) concentrations, sources of VOC, exposures, and effects of VOC in indoor air on health in Japan. Because the ratios of indoor concentration (I) to outdoor concentration (O) (I/O ratios) were larger than 1 for nearly all compounds, it is clear that indoor contaminations occur in Japan. However, the concentrations of basic compounds such as formaldehyde and toluene were decreased by regulation of guideline indoor values. Moreover, when the sources of indoor contaminations were investigated, we found that the sources were strongly affected by to outdoor air pollutions such as automobile exhaust gas. Since people live different lifestyles, individual exposures have been investigated in several studies. Individual exposures strongly depended on indoor concentrations in houses. However, outdoor air pollution cannot be disregarded as the sources of VOC. As an example of the effect of VOC on health, it has been indicated that there is a possibility of exceeding a permissible cancer risk level owing to exposure to VOC over a lifetime.

Environ Sci Technol. 2009 Nov 1;43(21):8338-43.
Uptake of aldehydes and ketones at typical indoor concentrations by houseplants.
Tani A, Hewitt CN.
Institute for Environmental Sciences, University of Shizuoka, Shizuoka 422-8526, Japan. [email protected]

The uptake rates of low-molecular weight aldehydes and ketones by peace lily (Spathiphyllum clevelandii) and golden pothos (Epipremnum aureum) leaves at typical indoor ambient concentrations (10(1)-10(2) ppbv) were determined. The C3-C6 aldehydes and C4-C6 ketones were taken up by the plant leaves, but the C3 ketone acetone was not. The uptake rate normalized to the ambient concentration C(a) ranged from 7 to 19 mmol m(-2) s(-1) and from 2 to 7 mmol m(-2) s(-1) for the aldehydes and ketones, respectively. Longer-term fumigation results revealed that the total uptake amounts were 30-100 times as much as the amounts dissolved in the leaf, suggesting that volatile organic carbons are metabolized in the leaf and/or translocated through the petiole. The ratio of the intercellular concentration to the external (ambient) concentration (C(i)/C(a)) was significantly lower for most aldehydes than for most ketones. In particular, a linear unsaturated aldehyde, crotonaldehyde, had a C(i)/C(a) ratio of approximately 0, probably because of its highest solubility in water.

Proc Am Thorac Soc. 2010 May;7(2):102-6.
Indoor air pollution and asthma in children.
Breysse PN, Diette GB, Matsui EC, Butz AM, Hansel NN, McCormack MC.
Department of Environmental Heath Sciences, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA. [email protected]

The purpose of this article is to review indoor air pollution factors that can modify asthma severity, particularly in inner-city environments. While there is a large literature linking ambient air pollution and asthma morbidity, less is known about the impact of indoor air pollution on asthma. Concentrating on the indoor environments is particularly important for children, since they can spend as much as 90% of their time indoors. This review focuses on studies conducted by the Johns Hopkins Center for Childhood Asthma in the Urban Environment as well as other relevant epidemiologic studies. Analysis of exposure outcome relationships in the published literature demonstrates the importance of evaluating indoor home environmental air pollution sources as risk factors for asthma morbidity. Important indoor air pollution determinants of asthma morbidity in urban environments include particulate matter (particularly the coarse fraction), nitrogen dioxide, and airborne mouse allergen exposure. Avoidance of harmful environmental exposures is a key component of national and international guideline recommendations for management of asthma. This literature suggests that modifying the indoor environment to reduce particulate matter, NO(2), and mouse allergen may be an important asthma management strategy. More research documenting effectiveness of interventions to reduce those exposures and improve asthma outcomes is needed.

HortScience 45: 1489-1495 (2010)
Variation in Formaldehyde Removal Efficiency among Indoor Plant Species
Kwang Jin Kim1, Myeong Il Jeong, Dong Woo Lee, Jeong Seob Song, Hyoung Deug Kim, Eun Ha Yoo, Sun Jin Jeong and Seung Won Han

The efficiency of volatile formaldehyde removal was assessed in 86 species of plants representing five general classes (ferns, woody foliage plants, herbaceous foliage plants, Korean native plants, and herbs). Phytoremediation potential was assessed by exposing the plants to gaseous formaldehyde (2.0 µL·L–1) in airtight chambers (1.0 m3) constructed of inert materials and measuring the rate of removal. Osmunda japonica, Selaginella tamariscina, Davallia mariesii, Polypodium formosanum, Psidium guajava, Lavandula spp., Pteris dispar, Pteris multifida, and Pelargonium spp. were the most effective species tested, removing more than 1.87 µg·m–3·cm–2 over 5 h. Ferns had the highest formaldehyde removal efficiency of the classes of plants tested with O. japonica the most effective of the 86 species (i.e., 6.64 µg·m–3·cm–2 leaf area over 5 h). The most effective species in individual classes were: ferns—Osmunda japonica, Selaginella tamariscina, and Davallia mariesii; woody foliage plants—Psidium guajava, Rhapis excels, and Zamia pumila; herbaceous foliage plants—Chlorophytum bichetii, Dieffenbachia ‘Marianne’, Tillandsia cyanea, and Anthurium andraeanum; Korean native plants—Nandina domestica; and herbs—Lavandula spp., Pelargonium spp., and Rosmarinus officinalis. The species were separated into three general groups based on their formaldehyde removal efficiency: excellent (greater than 1.2 µg·m–3 formaldehyde per cm2 of leaf area over 5 h), intermediate (1.2 or less to 0.6), and poor (less than 0.6). Species classified as excellent are considered viable phytoremediation candidates for homes and offices where volatile formaldehyde is a concern.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Flu and Vitamin D3

Flu and Vitamin DIn a sequestered environment such as a classroom or dormitory, influenza can evoke concerns that are more than just casual. It has been noted by scientists and physicians that seasonal variations in ultraviolet radiation from the sun parallel the outbreak of the flu. The more obvious the sun’s activity, the less pronounced are viral infections. The converse is also true. Places at high latitudes do not receive enough sunlight to help the body produce vitamin D, known for its ability to cause an immune response to pathogens.

Studies performed in Norway, at the Institute for Cancer Research at Oslo University Hospital, in 2010, stated definitively that, “Seasonal variations in ultraviolet B (UVB) radiation cause seasonal variations in vitamin D status.”  Immune response and seasonal influenza infection were directly related to vitamin D levels.  This conclusion was drawn from weekly records that monitored the number of influenza cases and flu-related deaths in Sweden, Norway, the United States, Singapore, and Japan in light of concomitant changes in UVB strength. Results of this study indicated that, “…influenzas mostly occur in the winter season in temperate regions,” adding that, “…at high latitudes very little, if any, vitamin D is produced in the skin during the winter.”  (Juzeniene. 2010)

Vitamin D deficiency is related to other matters besides the flu, including some cancers, heart disease, multiple sclerosis, diabetes, autism, and a host of others. (Cannell. 2008)  This pro-hormone has been produced by life forms since the Creation, and is vital to the growth and development of the organism, from gestation to the grave.  Of the common forms, D2 and D3, the latter is more biologically significant, since it is the one made by the skin in response to sunlight exposure.  The supplement is usually derived from either lanolin or cod liver oil.  This—D3— is the form that should be used to treat deficit.  The former, D2, comes from fungal sources by activating ergosterol with UV light, and is not naturally present in humans.  Synthetic, Rx forms are also available.

After being formed in the skin, vitamin D is converted into two different substances in the body. 25-hydroxyvitamin D (calcidiol) is the main storage form made by the liver.  1,25-dihydroxyvitamin D (calcitriol) is the most potent human steroid in the body, usually made in the kidneys. Calcitriol levels should not be used to determine vitamin D status.

Japanese research looked into seasonal flu among school children, from December 2008 to March 2009, and found that those who had not been taking vitamin D3 supplements were considerably more likely to get the flu than those who did supplement. Asthma sufferers experienced fewer exacerbations if they supplemented with the vitamin. (Urashima. 2010)

The sun has an eleven-year cycle during which its radiation level waxes or wanes.  Discovered in the 1840’s by Samuel Schwabe, the cycle can change the amount of UVB light reaching the earth by as much as 400%, more than enough to influence vitamin D stores.  The hypothesis that flu pandemics are associated with solar control of vitamin D levels has been developed and accepted. (Hayes. 2010)  Part of this is based on vitamin D’s ability to help the body make an innate antimicrobial peptide called cathelicidin, which depends upon vitamin D levels of 40 – 70 nanograms per milliliter.  (Cannell)  European researchers believe that the economic burden of the flu on that continent could be reduced by 187 billion euros a year by supplementing with 2000-3000 IU of vitamin D a day.  (Grant. 2009)  Food fortification, artificial UVB, and, of course, supplements are practical options when the sun is unable to do what we expect.

References

MAIN ABSTRACT
Int J Infect Dis. 2010 Dec;14(12):e1099-105. Epub 2010 Oct 29. The seasonality of pandemic and non-pandemic influenzas: the roles of solar radiation and vitamin D. Juzeniene A, Ma LW, Kwitniewski M, Polev GA, Lagunova Z, Dahlback A, Moan J.

Department of Radiation Biology, Institute for Cancer Research, the Norwegian Radium Hospital, Oslo University Hospital, Montebello, N-0310 Oslo, Norway. [email protected]

SUPPORTING ABSTRACTS
Altern Med Rev. 2008 Mar;13(1):6-20.
Use of vitamin D in clinical practice.
Cannell JJ, Hollis BW.

Am J Clin Nutr. 2010 May;91(5):1255-60. Epub 2010 Mar 10.
Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren.
Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H.

Medical Hypotheses. Volume 74, Issue 5, May 2010, Pages 831-834
Influenza pandemics, solar activity cycles, and vitamin D Daniel P. Hayes

Progress in Biophysics and Molecular Biology. 99(2-1); Feb-May 2009: 104-113
Estimated benefit of increased vitamin Dnext term status in reducing the economic burden of disease in western Europe William B. Grant, Heide S. Cross, Cedric F. Garland, et al

Journal of Clinical Virology Volume 50, Issue 3, March 2011, Pages 194-200
Vitamin D and the anti-viral state Jeremy A. Beard, Allison Bearden, and Rob Striker

Archives of Gerontology and Geriatrics
Article in Press, Corrected Proof – Received 15 October 2010; revised 25 February 2011; accepted 28 February 2011. Available online 1 April 2011.
Vitamin D: drug of the future. A new therapeutic approach N. Gueli, W. Verrusioa, A. Linguanti, F. Di Maio, A. Martinez, B. Marigliano and M. Cacciafesta

FASEB J. 2005 Jul;19(9):1067-77.
Human cathelicidin antimicrobial peptide (CAMP) gene is a direct target of the vitamin D receptor and is strongly up-regulated in myeloid cells by 1,25-dihydroxyvitamin D3. Gombart AF, Borregaard N, Koeffler HP

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Winterize Your Immune System

chilly-womanThe relationship between vitamin D status and the strength of the immune system is a hot topic. Actually a steroid hormone more than a vitamin, vitamin D is made by the skin after exposure to the ultraviolet radiation of the sun. Because the sun’s angle of incidence outside the tropics is considerably lower in winter, the skin’s response is too weak to manufacture sufficient stores of this vital nutrient.

In the early 1980’s, British physician R. Edgar Hope-Simpson proposed a relationship between solar radiation and the seasonality of influenza.  Without sufficient sunlight, the skin does not produce vitamin D, deficiency of which is common in winter.  This steroid hormone has considerable influence on immunity, where it prevents excessive expression of inflammation and is able to, “…stimulate the expression of potent anti-microbial peptides, which exist in neutrophils, monocytes, natural killer cells, and in epithelial cells lining the respiratory tract where they play a major role in protecting the lung from infection.”   (Cannell. 2006)   This study, performed at California’s Atascadero State Hospital, states that deficiency of vitamin D predisposes children to respiratory infections.  UV radiation, either natural or artificial, increases vitamin D levels and thereby reduces the incidence of pulmonary infections.

Vitamin D deficiency has been associated with many of the diseases of modern society, but traditional medicine has been reluctant to address this concern, or even to recognize it.  This vitamin is the only known precursor to a potent steroid hormone that is able to regulate expression in a number of tissues.  It does not exist in appreciable amounts in the diet, not even in fortified foods like dairy.  People used to make enormous amounts of vitamin D until they were warned to stay out of the sun.  If not exposed to the sun, we need to get it from supplements.  The flu epidemic of 1918 took a great toll.  Autopsies on some of the fifty million people who died revealed destruction of the respiratory tract.  This is the inflammation that vitamin D has been found to prevent.

Randomized, double-blind, placebo-controlled studies done in Japan in 2010 found that vitamin D3 supplementation not only reduced incidence of influenza type A, but also reduced asthma attacks as a secondary outcome. (Urashima. 2010).  The elderly tend to have suboptimal levels of vitamin D, which is associated with an increased risk of falls as well as seasonal virus attacks.  Vitamin D supplementation in this group is a realistic intervention that can pay large dividends.  2000 IU a day has been suggested as a minimal dose also to help prevent osteoporosis, increased risk of certain cancers, aberrant glucose and lipid metabolism and to improve quality of life.  (Lawless. 2011)  (Cherniak.  2008). Solar activities of the sun have a cycle of about eleven years, and an interesting phenomenon is that flu epidemics seems to follow the pattern.  (Hayes.  2010).

Vitamin D is not the sole player in the winterizing game.  Viruses need to get into your cells to make copies of themselves, using your cellular materials.   Replication of the flu virus is interrupted by a standardized elderberry extract called Sambucol, the use of which brought improvement to more than 90% of the persons in a study group within two days.  Since there is no satisfactory medication to cure the flu, this natural substance is nearly miraculous because it’s also inexpensive, has no side effects, and works on both A and B strains of influenza.  (Zakay-Rones.  1995)  (Zakay-Rones.  2004). The anti-viral properties of elderberry are attributed to its flavonoids content, some of which are peculiar to that plant alone. (Roschek. 2009).

A considerable part of the immune system resides in the gut, where intestinal microflora work to maintain the status quo.  Keeping those bacteria happy and healthy makes sense, so probiotics have been examined as a support system.  In a controlled study in Wisconsin, scientists found that six months of supplementation with a probiotic resulted in reduced fever, runny nose, and cough incidence in youngsters aged 3 to 5 years.  Duration of prescription medications and missed school days also were reduced.  (Leyer. 2009)  Day care centers across the Atlantic also fared well in the reduction of childhood infections with probiotic use. In Finland, researchers saw a substantial reduction in respiratory infections and their severity among children under 6 years old, accompanied by a reduction in the need for antibiotic treatment in those who received probiotic dairy products.  (Hatakka.  2001)

Investigations of echinacea as treatment for flu were not as positive as those for prevention.  It was discovered that early intervention, at the fist symptoms, brought the best results using an echinacea compound tea, namely one called Echinacea Plus.  (Lindenmuth.  2000).  Because there are too many variables, including the part or parts of the plant used, the brewing times and techniques, the variety of the plant used, its cultivation conditions, and other factors, test results are likely to differ.  Even in trials with sound methodology, results may conflict.  (Melchart.  2000)  (Linde. 2006) Using echinacea as prevention or as treatment, then, may be an uncertain proposition.

There is more to consider.  Garlic and onions have putative anti-bacterial and anti-viral properties. (Goncagul. 2010). (Harris. 2001)  Exercise, regardless of intensity or duration, and sound sleep of uninterrupted duration help the lymphatic system to clear impurities and to boost immunity.  One or all of these suggestions might be your ounce of prevention.  Oh, yeah, one last thing.  The higher the humidity in your house in the winter, the less likely viruses are to be transmitted.  (Lowen,. 2007)  (Yang. 2011)

References

MAIN ABSTRACT
Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, Garland CF, Giovannucci E. Epidemic influenza and vitamin D. Epidemiol Infect. 2006 Dec;134(6):1129-40.

SUPPORTING ABSTRACTS
Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H.
Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren.
Am J Clin Nutr. 2010 May;91(5):1255-60. Epub 2010 Mar 10.

Lawless S, White P, Murdoch P, Leitch S.
(Preventing) two birds with one stone: improving vitamin D levels in the elderly.
J Prim Health Care. 2011 Jun 1;3(2):150-2.

Cherniack EP, Levis S, Troen BR.
Hypovitaminosis D: a widespread epidemic.
Geriatrics. 2008 Apr;63(4):24-30.

Hayes DP.
Influenza pandemics, solar activity cycles, and vitamin D.
Med Hypotheses. 2010 May;74(5):831-4. Epub 2009 Dec 28.

Zakay-Rones Z, Varsano N, Zlotnik M, Manor O, Regev L, Schlesinger M, Mumcuoglu M.
Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama.
J Altern Complement Med. 1995 Winter;1(4):361-9.

Zakay-Rones Z, Thom E, Wollan T, Wadstein J.
Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections.
J Int Med Res. 2004 Mar-Apr;32(2):132-40.

Roschek B Jr, Fink RC, McMichael MD, Li D, Alberte RS.
Elderberry flavonoids bind to and prevent H1N1 infection in vitro.
Phytochemistry. 2009 Jul;70(10):1255-61.

Leyer GJ, Li S, Mubasher ME, Reifer C, Ouwehand AC
Probiotic effects on cold and influenza-like symptom incidence and duration in children.
Pediatrics. 2009 Aug;124(2):e172-9.

Hatakka K, Savilahti E, Pönkä A, Meurman JH, Poussa T, Näse L, Saxelin M, Korpela R.
Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial.
BMJ. 2001 Jun 2;322(7298):1327

Brinkeborn RM, Shah DV, Degenring FH.
Echinaforce and other Echinacea fresh plant preparations in the treatment of the common cold. A randomized, placebo controlled, double-blind clinical trial.
Phytomedicine. 1999 Mar;6(1):1-6.

Lindenmuth GF, Lindenmuth EB
The efficacy of echinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms: a randomized, double-blind placebo-controlled study.
J Altern Complement Med. 2000 Aug;6(4):327-34.

Melchart D, Linde K, Fischer P, Kaesmayr J.
Echinacea for preventing and treating the common cold.
Cochrane Database Syst Rev. 2000;(2):CD000530.

Linde K, Barrett B, Wölkart K, Bauer R, Melchart D.
Echinacea for preventing and treating the common cold.
Cochrane Database Syst Rev. 2006 Jan 25;(1):CD000530.

Goncagul G, Ayaz E.
Antimicrobial effect of garlic (Allium sativum).
Recent Pat Antiinfect Drug Discov. 2010 Jan;5(1):91-3.

Harris JC, Cottrell SL, Plummer S, Lloyd D.
Antimicrobial properties of Allium sativum (garlic).
Appl Microbiol Biotechnol. 2001 Oct;57(3):282-6.

Lowen AC, Mubareka S, Steel J, Palese P.
Influenza virus transmission is dependent on relative humidity and temperature.
PLoS Pathog. 2007 Oct 19;3(10):1470-6.

Wan Yang, Linsey C. Marr
Dynamics of Airborne Influenza A Viruses Indoors and Dependence on Humidity
PLoS ONE: Research Article, published 24 Jun 2011 10.1371/journal.pone.0021481

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Mold In Your Cellar?

water-damaged-basement-wallThere are wet clothes on the line downstairs. Last night’s rain storm left a few puddles on the floor near the cellar windows. It feels a few degrees warmer in the cellar than in the kitchen because it’s more humid. Situations like this create a breeding ground for mold, one of the fungus kingdom. Molds are everywhere, and are a common component of dust. Large quantities of mold can become a health hazard, causing allergic reactions and respiratory problems. Those few that produce mycotoxins can pose a serious risk to human health, and are the “toxic molds” of conversation. One of the most infamous is called Stachybotrys chartarum, more commonly found outside than in, but an occasional resident of flooded buildings. Molds can live on plants, foods, dry leaves, and other organic matter, but can also grow on hard surfaces.

Molds are produced by spores, which can be carried by air currents because they are tiny and lightweight. Fungi in general are necessary to the food chain as decomposers. But as molds inside your house they can cause a myriad of problems. For significant mold growth to happen there needs to be a source of dampness, a source of food, and a substrate capable of sustaining growth. Building supplies, including carpets, plywood, sheetrock, and other porous materials, are ideal places for molds to live and grow. Cellulose is one of their favorites. A single incident of water damage can encourage mold to live inside a wall, later to be resurrected from near dormancy by high humidity. Identifying the source of humidity is an important step in resolution. Even the steam from a stovetop or the shower, the watering of houseplants or the use of a central humidifier can exacerbate—or even initiate—a mold problem.

The health effects of mold exposure include allergic reactions, eye and respiratory irritation, infection, and toxicity. About five percent of individuals are predicted to have some airway symptom from molds over their lifetimes. Wherever and whenever mold infestation is identified it needs to be remediated.

If the cellar is where the kids play when the outdoors is uninviting, paying attention to the presence of mold is important. If enough is there, you’ll be able to smell it, even if you can’t see it. If the mold is growing in black streaks and looks slimy, it could be Stachybotrys chartarum, and is usually indicative of poor indoor air quality. If the texture is fuzzy or matte, it’s likely another strain, such as Aspergillus or Fusarium. Regardless of what it is, it is advisable not to touch it or to inhale deeply when you examine it.

Sometimes you’ll see condensation on your (cellar) windows or walls. This might mean there’s a combustion problem with an appliance. Is the dryer properly vented?  How about the furnace and water heater?  Too little air to the furnace can cause back drafting, which is also a carbon monoxide threat. Using a de-humidifier in the cellar, especially if it’s unheated, is sound practice. If your dryer is vented into a bucket of water to trap lint because outdoor venting is difficult or impossible, and if the cellar lacks heat, the damp air from the dryer can condense once it contacts the cold walls. Hence the rationale for a dehumidifier. A fan can desiccate the air enough to deny mold a happy home.

The dryness of indoor wintertime air can cause static electricity, shrinking and warping of furniture, skin irritation, and even bloody noses. At 40% humidity, most of us are reasonably comfortable. Increasing indoor humidity to prevent problems is O.K. as long as there is no condensation inside the living room windows. Cold air cannot hold much moisture, and a heater dries it out even more. Being overzealous with humidification can create conditions favorable to mold, which prefers temperatures between 77° F. and 85° F, but can survive anywhere between 32° and 95°.   Unless there are symptoms of mold sensitivity, testing is unnecessary. If it is done, it should be performed by a trained professional. In a baseline home, mold spore counts may range from 300 to 1200 spores per cubic meter. Counts above 1000 suggest a mold problem. (Rockwell, 2005)  On the other hand, there are no regulations that outline acceptable mold counts

Simple steps to remedy a small occurrence start with sunshine, improved ventilation, additional insulation in the walls, and dehumidification. But these do not get rid of what’s already present; they only make it non-viable. Simply killing mold is not enough. It has to be removed because the chemicals and proteins that evoke a reaction are still present in dead mold. Using bleach will only make it lighter in color and fail to kill the roots. Why?  Because bleach is mostly water, and water is what mold needs to thrive.  The active ingredient in bleach, often sodium hypochlorite, is weakened. A stronger product than what we get from a store is dangerous. Not only that, bleach will only work on non-porous surfaces, like tubs and tiles. It does not penetrate porous materials, even concrete, so it can’t get to the roots, and the mold will return. It does, however, change the color. Some people think that if they can’t see any mold, all is well.

Borax and straight white vinegar can kill mold, but you have to be patient. Borax has to be mixed with water, but is strong enough and safe enough to do the job. Neither product needs to be rinsed. If you don’t care about spending money, tea tree oil is a great antifungal, using a teaspoon per cup of water in a spray bottle. It’s safe to humans and animals, and is one of the best mold slayers. People use it on cuts and scrapes because it’s also antibacterial. Any residue will prevent recurrence of mold. A novel product in the fight against mold is grapefruit seed extract, used to fight bacterial, yeast and viral infections. The citric acid seems to be the active component. Ten drops of this go into a cup of water in a spray bottle. It’ll kill the mold down to its roots. If a mold problem is severe, get a professional to do the job, but make sure he’s qualified.

References

http://blackmold.awardspace.com/kill-remove-mold.html

Hardin BD, Kelman BJ, Saxon A.
Adverse human health effects associated with molds in the indoor environment.
J Occup Environ Med. 2003 May;45(5):470-8.

Koburger T, Below H, Dornquast T, Kramer A.
Decontamination of room air and adjoining wall surfaces by nebulizing hydrogen peroxide.
GMS Krankenhhyg Interdiszip. 2011;6(1):Doc09.

Kuhn DM, Ghannoum MA.
Indoor mold, toxigenic fungi, and Stachybotrys chartarum: infectious disease perspective.
Clin Microbiol Rev. 2003 Jan;16(1):144-72.

Mudarri D, Fisk WJ.
Public health and economic impact of dampness and mold.
Indoor Air. 2007 Jun;17(3):226-35.

Robbins CA, Swenson LJ, Nealley ML, Gots RE, Kelman BJ
Health effects of mycotoxins in indoor air: a critical review.
Appl Occup Environ Hyg. 2000 Oct;15(10):773-84.

Rockwell W.
Prompt remediation of water intrusion corrects the resultant mold contamination in a home.
Allergy Asthma Proc. 2005 Jul-Aug;26(4):316-8.

Terr AI.
Are indoor molds causing a new disease?
J Allergy Clin Immunol. 2004 Feb;113(2):221-6.

U.S. Environmental Protection Agency
“A Brief Guide to Mold. Moisture, and Your Home”
www.eps.gov/mold/whattowear.html

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Is Sugar Affecting Your Immunity?

sweet-drinkThere is a metabolic difference between simple and complex carbohydrates.  The simple ones become glucose soon after they are eaten.  The complex ones take longer to turn into sugar and are less apt to spike insulin and cause energy crashes down the line.  But that isn’t the only difference between the two.

Almost forty years ago scientists had an interest in the relationship of diet to health, specifically of sugar intake to immunity.   But their curiosity went past simple sugar to include carbohydrates other than glucose.  The cells that are the backbone of the immune system are supposed to kill, swallow, and dispose of alien bodies, including bacteria, viruses and cancer cells.  Scientists at Loma Linda University in California examined the activity of neutrophilic phagocytes (cells that dissolve the enemy) after subjects ingested glucose, fructose, sucrose, honey, or orange juice and found that “…all significantly decreased the capacity of neutrophils to engulf bacteria…”  (Sanchez, Reeser, et al. 1973)  Looking more closely, the researchers also discovered that the greatest effects occurred within the first two hours after eating, but “…the effects last for at least 5 hours.”  (Ibid.)  If there is any promise, it’s that the effects can be undone by fasting from added sugars for the next two or three days.

At the start of the twentieth century, Americans consumed only about five pounds of sugar a year.  By the fifties, that had grown to almost 110 pounds a year, and to more than 152 by the year 2000.  Corn sweeteners account for 85 of those pounds.
(USDA Economic Research Service, http://www.usda.gov/factbook/chapter2.pdf )  America’s sweet tooth increased 39% between 1950 and 2000 as the use of corn sweetener octupled.

Although the cited study is decades old, its message is contemporary. HFCS began replacing sugar in soft drinks in the 1980’s, after it was portrayed by marketers as a healthful replacement for demon sugar.  It didn’t hurt the industry that it cost less, either.  The biological effects of sugar and HFCS are the same, however.  Neither has any food value—no vitamins, protein, minerals, antioxidants, or fiber—but they do displace the more nutritious elements of one’s diet, and we tend to consume more than we need to maintain our weight, so we gain.

Even though the number of calories from the glucose in a slice of bread or other starch is the same as that from table sugar (half fructose and half glucose), they are metabolized differently and have different effects on the body.  While fructose is metabolized by the liver, glucose is metabolized by every cell in the body.  When fructose reaches the liver, especially in liquid form (as in soda), it overwhelms the organ and is almost immediately converted to fat.  (Taubes. 2011)

Innate immunity is that which occurs as part of your natural makeup and defends you against infection by other organisms.  Short-term hyperglycemia, which might come from a pint of vanilla, has been found to affect all the major components of the innate immune system and to impair its ability to combat infection.  Reduced neutrophil activity, but not necessarily reduced neutrophil numbers, is one of several reactions to high sugar intake.  (Turina. 2005)  Way back in the early 1900’s, researchers noted a relationship between glucose levels and infection frequency among diabetes sufferers, but it wasn’t until the 1940’s that scientists found that diabetics’ white cells were sluggish. (Challem. 1997)  More recent study has corroborated the diabetes-infection connection, agreeing that neutrophil phagocytosis is impaired when glucose control is less than adequate.  (Lin. 2006)  Impaired immune activity is not limited to those with diabetes.  As soon as glucose goes up, immune function goes down.

Some folks think they’re doing themselves a favor by using artificial sweeteners.  Once the brain is fooled into thinking a sweet has been swallowed, it directs the pancreas to make insulin to carry the “sugar” to the cells for energy.  After the insulin finds out it’s been cheated of real sugar, it tells the body to eat in order to get some, and that creates artificial hunger, which causes weight increase from overeating.   Even environmental scientists have a concern with fake sweeteners in that they appear in the public’s drinking water after use.  You can guess how that works. (Mawhinney. 2011)

Mineral deficiencies, especially prevalent in a fast-food world, contribute to immune dysfunction by inhibiting all aspects of the system, from immune cell adherence to antibody activity.  Paramount among minerals is magnesium, which is part of both the innate and acquired immune responses.  (Tam. 2003)  Epidemiological studies have connected magnesium intake to decreased incidence of respiratory infections, and intravenous administration has shown effective in treating asthma. (PDR. 2000)  But sugar pushes magnesium—and other minerals—out of the body.  (Milne. 2000)  This will compromise not only immune function, but also bone integrity.  (Tjäderhane. 1998)

Zinc has been touted for its ability to shorten the duration of the common cold.  Like magnesium, zinc levels decrease with age, and even tiny deficiencies can have a large effect on immune health, particularly in the function of the thymus gland, which makes the T-cells of the immune system.  Zinc supplementation improves immune response in both the young and the old.  (Haase. 2009)  (Bogden. 2004)  (Bondestam. 1985)  All the microminerals, in fact, are needed in minute amounts for optimal growth and development…and physiology.  Low intakes suppress immune function by affecting T-cell and antibody response. Thus begins a cycle whereby infection prevents uptake of the minerals that could prevent infection in the first place.  Adequate intakes of selenium, zinc, copper, iron plus vitamins B6, folate, C, D, A, and E have been found to counteract potential damage by reactive oxygen species and to enhance immune function.  (Wintergest. 2007)

Who would have viewed something as sweet as sugar as being so hostile? It taste great to eat but has a nasty habit of pushing everything else out.

References

Albert Sanchez, J. L. Reeser, H. S. Lau, P. Y. Yahiku, et al
Role of sugars in human neutrophilic phagocytosis
American Journal of Clinical Nutrition, Nov 1973; Vol 26, 1180-1184

Profiling Food Consumption in America
USDA
http://www.usda.gov/factbook/chapter2.pdf

Taubes G.
“Is Sugar Toxic?”
in New York times Magazine, 13 April, 2011

Turina M, Fry DE, Polk HC Jr.
Acute hyperglycemia and the innate immune system: clinical, cellular, and molecular aspects.
Crit Care Med. 2005 Jul;33(7):1624-33.

Challem J and Heumer RP.
The Natural health Guide to Beating the Supergerms.
1997. Simon and Schuster Inc. New York.  Pp. 124-125

Lin JC, Siu LK, Fung CP, Tsou HH, Wang JJ, Chen CT, Wang SC, Chang FY.
Impaired phagocytosis of capsular serotypes K1 or K2 Klebsiella pneumoniae in type 2 diabetes mellitus patients with poor glycemic control.
J Clin Endocrinol Metab. 2006 Aug;91(8):3084-7.

Mawhinney DB, Young RB, Vanderford BJ, Borch T, Snyder SA.
Artificial sweetener sucralose in U.S. drinking water systems.
Environ Sci Technol. 2011 Oct 15;45(20):8716-22.

Tam M, Gómez S, González-Gross M, Marcos A.
Possible roles of magnesium on the immune system.
Eur J Clin Nutr. 2003 Oct;57(10):1193-7.

PDR:  Physicians’ Desk reference for Herbal Medicines.  Magnesium.  2nd edition.  Mintvale NJ: Medical Economics Company; 2000:  5340540

Milne David B, PhD and Forrest H. Nielsen, PhD
The Interaction Between Dietary Fructose and Magnesium Adversely Affects Macromineral Homeostasis in Men
J Am Coll Nutr February 2000 vol. 19 no. 1 31-37

Tjäderhane Leo, and Markku Larmas
A High Sucrose Diet Decreases the Mechanical Strength of Bones in Growing Rats
J. Nutr. October 1, 1998 vol. 128 no. 10 1807-1810

Fuchs, Nan Kathryn Ph.D.
Magnesium: A Key to Calcium Absorption
The Magnesium Web Site on November 22, 2002
http://www.mgwater.com/calmagab.shtml

Haase H, Rink L.
The immune system and the impact of zinc during aging.
Immun Ageing. 2009 Jun 12;6:9.

Bogden JD.
Influence of zinc on immunity in the elderly.
J Nutr Health Aging. 2004;8(1):48-54.

Bondestam M, Foucard T, Gebre-Medhin M.
Subclinical trace element deficiency in children with undue susceptibility to infections.
Acta Paediatr Scand. 1985 Jul;74(4):515-20.

Wintergerst ES, Maggini S, Hornig DH.
Contribution of selected vitamins and trace elements to immune function.
Ann Nutr Metab. 2007;51(4):301-23. Epub 2007 Aug 28.

Smolders I, Loo JV, Sarre S, Ebinger G, Michotte Y.
Effects of dietary sucrose on hippocampal serotonin release: a microdialysis study in the freely-moving rat.
Br J Nutr. 2001 Aug;86(2):151-5.

Jack Challem, Burton Berkson, M.D., Ph.D., Melissa Diane Smith
Glucose and Immunity
http://www.diabeteslibrary.org/View.aspx?url=Article638
Accessed 11/2011

Van Oss CJ.
Influence of glucose levels on the in vitro phagocytosis of bacteria by human neutrophils.
Infect Immun. 1971 Jul;4(1):54-9.

Bernstein J, Alpert S, et al
Depression of lymphocyte transformation following oral glucose ingestion
Am J Clin Nutr. 1977; 30: 613

Robert A. Good, Ellen Lorenz
Nutrition and cellular immunity
International Journal of Immunopharmacology. Vol 14, Iss 3, Apr 1992, Pp. 361-366

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Treat Your Asthma Gingerly

ginger-rootIf numbers can be trusted (99% of all statistics being made up on the spot), there are almost 25 million cases of asthma in the United States. Out of almost 314 million people in the country, that equates to almost 8% of the population. More than 3,000 Americans die from asthma each year. The annual cost for prescription drugs exceeds 6 billion dollars, and, as reported in 2012, asthma cases have increased 48% in the last ten years. (http://www.statisticbrain.com/asthma-statistics/, from the American Lung Association). Wow, that’s quite an indictment.

Asthma is a condition in which airways become narrowed, swell and produce extra mucus, making it difficult to breathe. It triggers coughing, wheezing and shortness of breath. For the lucky few, it’s only a minor nuisance; for others, it can be a major problem that interferes with daily life and might lead to a life-threatening asthma attack. Although asthma has no cure, it can be controlled. Once in a while symptoms flare up in certain situations, such as the exercise-induced asthma that worsens when the air is cool and dry, or the occupational asthma that assaults people in a workplace where exposure to fumes, chemicals or gases are the norm.

The odds of developing the condition increase among smokers, those whose mothers smoked during pregnancy, those assailed by second-hand smoke, people having other allergic conditions, or those having a blood relative with asthma. Symptoms that interfere with sleep, work or recreational activities need serious attention and a visit to a physician.

The inhaled corticosteroids commonly prescribed to treat asthma claim to have fewer adverse effects than the oral steroids used for other inflammatory conditions, such as arthritis and allergies. But that is purely subjective. These medications are used for the long haul, as are the oral leukotriene modifiers that include Singulair and its kin. Leukotrienes are endogenous chemicals that mediate responses in allergic reactions and inflammation, and their modification with drugs is linked, albeit weakly, to psychological reactions characterized by aggression, agitation, hallucinations, depression and suicidal thoughts. No completed suicides have been reported, however (Philip, 209). That’s reassuring. Yep. Other medications are used in combination with inhaled corticosteroids, but have the nasty habit of occasional exacerbation of symptoms. A drug seldom used nowadays is theophylline, a pill that relaxes the muscles around the airways to keep them open. Originally extracted from tea leaves and later found in cocoa, theophylline is one hundred percent bioavailable, but its side effects are equally disturbing, and are worsened in the presence of fatty meals.

But the future is bright. On the horizon are compounds extracted from ginger, the zingy spice that livens up our baked goods. Traditionally used to treat stomach upset, including that from motion sickness (Langner, 1998), ginger has found its way into the grab bag of integrative medicine, where its anti-inflammatory nature finds favor with sufferers of arthritis, hypercholesterolemia (Madkor, 2011), elevated glucose (Akhani, 2004), and even hypertension (Ghayur, 2005) and worms (Mostafa, 2011) (Lin, 2010).

Researchers at Columbia University have discovered that the bronchoconstriction of asthma can be attenuated with ginger compounds that work synergistically with  medications called beta-agonists, the best-known probably being Albuterol. The relaxation of airway smooth muscle is the goal. When the drug and the natural components were combined, relaxation response was remarkable (Townsend, 2013). Of the ginger isolates, one called 6-shogaol was most effective in its relaxing effects. This constituent of ginger is similar in structure to the better-known gingerol, the most active ingredient of the herb which is related to compounds appearing in chilies and black pepper, capsaicin and piperine respectively. Shogaol is produced when ginger is dried or cooked. As far as pungency, it falls between capsaicin and piperine on the heat scale.

In the lungs there is an enzyme called PDE4D which interferes with the relaxation of the airways. The elements of ginger stop this enzyme from flaunting its attributes. To further aggravate asthma, there also exists a protein structure that plays a role in the constriction of airways and the contraction of muscles, named F-actin filament.
6-shogaol dissolves these filaments rapidly. While there is support for the idea that asthma can be outgrown as musculature matures (Chitano, 2005), there is comfort in knowing that management of the disease is readily obtainable and that all-natural adjuvants are in the offing. Calcium signaling is part of the muscle contraction process. With some blood pressure medicines, calcium is inhibited and vessels relax to allow the smooth passage of blood. It was found that ginger has an activity like that of verapamil, a calcium-channel blocker, in that it can ease the contraction of the smooth muscle that controls airways (Ghayur, 2008).

In the decade preceding the 21st century, plants have been documented to be useful in the treatment of various respiratory disorders, including asthma. In fact, the use of natural products has increased dramatically all over the world. Not only have they affected bronchodilation, but also mast cell stabilization, anaphylaxis, and overall leukotriene modulation (Mali, 2011). (Mast cells, by the way, are those that release histamine in response to injury, allergy or inflammation.) To the delight of alternative-minded practitioners, many of these medicinal plants provide relief of symptoms equal to allopathic medicines (Bielory, 1999).

We might be reminded to enjoy our spices, especially those with anti-inflammatory characteristics, such as ginger and its close cousin, turmeric, but to be prudent if taking blood thinners. That the therapeutic value of ginger is enhanced by its mineral constituents (Latona, 2012) adds another dimension to the study of its universal appreciation.

References

Akhani SP, Vishwakarma SL, Goyal RK.
Anti-diabetic activity of Zingiber officinale in streptozotocin-induced type I diabetic rats.
J Pharm Pharmacol. 2004 Jan;56(1):101-5.

Bielory L, Lupoli K.
Herbal interventions in asthma and allergy.
J Asthma. 1999;36(1):1-65.

Chitano P, Wang L, Murphy TM.
Mechanisms of airway smooth muscle relaxation during maturation.
Can J Physiol Pharmacol. 2005 Oct;83(10):833-40.

Ghayur MN, Gilani AH.
Ginger lowers blood pressure through blockade of voltage-dependent calcium channels.
J Cardiovasc Pharmacol. 2005 Jan;45(1):74-80.

Ghayur MN, Gilani AH, Janssen LJ.
Ginger attenuates acetylcholine-induced contraction and Ca2+ signalling in murine airway smooth muscle cells.
Can J Physiol Pharmacol. 2008 May;86(5):264-71.

Hirst SJ.
Airway smooth muscle as a target in asthma.
Clin Exp Allergy. 2000 Jun;30 Suppl 1:54-9.

Langner E, Greifenberg S, Gruenwald J.
Ginger: history and use.
Adv Ther. 1998 Jan-Feb;15(1):25-44.

Latona DF, Oyekele GO, Olayiwola OA
Chemical analysis of Ginger Root
IOSR Journal of Applied Chemistry (IOSRJAC). Volume 1, Issue 1; May/June 2012: 47-49

Levy AS, Simon O, Shelly J, Gardener M.
6-Shogaol reduced chronic inflammatory response in the knees of rats treated with complete Freund’s adjuvant.
BMC Pharmacol. 2006 Oct 1;6:12.

Lin RJ, Chen CY, Lee JD, Lu CM, Chung LY, Yen CM.
Larvicidal constituents of Zingiber officinale (ginger) against Anisakis simplex.
Planta Med. 2010 Nov;76(16):1852-8.

H Ling, H Yang, S-H Tan, W-K Chui, E-H Chew
6-Shogaol, an active constituent of ginger, inhibits breast cancer cell invasion by reducing matrix metalloproteinase-9 expression via blockade of nuclear factor-κB activation
British Journal of Pharmacology. Volume 161, Issue 8, pages 1763–1777, December 2010

Madkor HR, Mansour SW, Ramadan G.
Modulatory effects of garlic, ginger, turmeric and their mixture on hyperglycaemia, dyslipidaemia and oxidative stress in streptozotocin-nicotinamide diabetic rats.
Br J Nutr. 2011 Apr;105(8):1210-7.

Mali RG, Dhake AS.
A review on herbal antiasthmatics.
Orient Pharm Exp Med. 2011 Aug;11(2):77-90.

Mostafa OM, Eid RA, Adly MA.
Antischistosomal activity of ginger (Zingiber officinale) against Schistosoma mansoni harbored in C57 mice.
Parasitol Res. 2011 Aug;109(2):395-403.

Philip G, Hustad C, Noonan G, Malice MP, Ezekowitz A, Reiss TF, Knorr B.
Reports of suicidality in clinical trials of montelukast.
J Allergy Clin Immunol. 2009 Oct;124(4):691-6.e6.

Ramji, Divya; ho, chi; Huang, Qingron; Rafi, Mohamed; Huang, Mou
Isolation of gingerols and shogaols from ginger and evaluation of their chemopreventive activity on prostate cancer cells and anti-inflammatory effect on 12-O-tetradecanoyl-phorbol-13-acetate (TPA)-induced mouse ear inflammation
RUcore – Rutgers University Community Repository. 2007
http://mss3.libraries.rutgers.edu/dlr/showfed.php?pid=rutgers-lib:21328

Sehwan Shima, Sokho Kima, Dea-Seung Choia, Young-Bae Kwonb, Jungkee Kwona
Anti-inflammatory effects of [6]-shogaol: Potential roles of HDAC inhibition and HSP70 induction
Food and Chemical Toxicology. Volume 49, Issue 11, November 2011, Pages 2734–2740

Townsend EA, Yim PD, Gallos G, Emala CW.
Can we find better bronchodilators to relieve asthma symptoms?
J Allergy (Cairo). 2012 ;2012:321949. doi: 10.1155/2012/321949. Epub 2012 Oct 2.

Townsend EA, Siviski ME, Zhang Y, Xu C, Hoonjan B, Emala CW.
Effects of ginger and its constituents on airway smooth muscle relaxation and calcium regulation.
Am J Respir Cell Mol Biol. 2013 Feb;48(2):157-63.

Wang L, Pozzato V, Turato G, Madamanchi A, Murphy TM, Chitano P.
Reduced spontaneous relaxation in immature guinea pig airway smooth muscle is associated with increased prostanoid release.
Am J Physiol Lung Cell Mol Physiol. 2008 May;294(5):L964-73.

Wu H, Hsieh MC, Lo CY, Liu CB, Sang S, Ho CT, Pan MH.
6-Shogaol is more effective than 6-gingerol and curcumin in inhibiting 12-O-tetradecanoylphorbol 13-acetate-induced tumor promotion in mice.
Mol Nutr Food Res. 2010 Sep;54(9):1296-306.

Zick SM, Djuric Z, Ruffin MT, Litzinger AJ, Normolle DP, Alrawi S, Feng MR, Brenner DE.
Pharmacokinetics of 6-gingerol, 8-gingerol, 10-gingerol, and 6-shogaol and conjugate metabolites in healthy human subjects.
Cancer Epidemiol Biomarkers Prev. 2008 Aug;17(8):1930-6.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.