Background of the Study:
I am interested in researching into evidence based or scientifically proven alternative remedies and its impact on health. Today modern day diseases are so complex for one treatment modality to treat it. The Conventional Medical Practitioners claim that alternative remedies are not scientifically proven –that is, no research backing the alternative practitioners claim. Hence, they coined the term alternative medicine for any practice that is outside their jurisdiction.
So now my question is: if there are lots of researches to back some of the alternative remedies to treat diseases with no side effects, are they still going to maintain the name alternative medicine as the treatments are scientifically proven or validated with supporting references?
Well, I have decided to research extensively on all the alternative systems that have been extensively researched and scientifically proven to manage diseases and are as effective as conventional medicine to bring to the limelight.
I have now coined the term “Allopathic Alternative Medicine” to start a new form of alternative medicine which are scientifically proven alternative remedies. I have started with Hibiscus and it has really awakened the system
Hibiscus sabdariffa, or Sobolo tea known in Ghana, is a genus of the Malvaceae family as I said in my previous publications. Approximately 15%-30% of the plant is made up of plant acids, including citric, malic, tartaric acids and allo-hydroxycitric acid lactone—i.e. hibiscus acid which is specific to this plant. Other chemical ingredients are numerous as I researched on, including alkaloids, L-ascorbic acid, anthocyanin, Beta-carotene, Beta-sitosterol, citric acid, polysaccharides arabins and arabinogalactans, quercetin, gossypetin and small amounts of galactose, arabinose, glucose, xylose, mannose and rhamnose.
Hibiscus is frequently used in amalgamation with lemon balm and St John’s wort for restlessness and poor sleep onset.
In this publication, I have specifically focused on summarizing the body of evidence on its use in the management of cardiovascular diseases. Archaeologically, folk medicine has used H. sabdariffa for the treatment of high blood pressure, liver diseases and fevers. In enormous volumes, hibiscus tea acts as a mild laxative. In Iran, it is a traditional treatment for high blood pressure which is the focus of several studies, as is cholesterol reduction. It is understood that the antioxidant and diuretic effects of hibiscus are its most important mechanisms in lowering blood pressure. It is as effective as conventional or allopathic medicine for treating blood pressure.
Research on Cardiovascular Claims
Scientific research interest in Hibiscus has developed in the last several years with a few rupture of published research studies, especially in the area of dyslipidemia and hypertension. Over twenty years ago, water extracts of hibiscus flowers were reported to have a relaxation effect on the uterus and to lower the blood pressure. Studies in both animal and human models have established that extracts or infusions affect atherosclerosis mechanisms, blood sugar, lipids and blood pressure. The following are the body of evidence of the Hibiscus tea research:
1. In 2007, a clinical trial showed that Hibiscus reduced cholesterol by 8.3% to 14.4% after just one month. The study employed a total of 42 subjects and randomized to 3 groups for the study, conducted in Taiwan. The hibiscus extract capsules contained 500 mg of dried herb by softening 150 g of hibiscus flowers in 6 L of hot water for 2 hours and then drying and filtering the extract. The Group 1 received 1 capsule of extract 3 times daily (1,500 mg/day), the second group 2 received 2 capsules 3 times daily (3,000 mg/day), and finally the group 3 received 3 capsules 3 times daily (4,500 mg/day) Overall, subjects in group 2 responded best to the hibiscus extract treatment.
Groups 1 and 2, but not group 3, experienced a substantial reduction in serum cholesterol levels at week 4, compared with baseline levels. In addition, group 2 experienced a significant reduction in serum cholesterol levels at week 2, compared with baseline levels. At week 2, there was a 42.9% respondent rate in groups 1 and 3 and a 64.3% respondent rate in group 2. By week 4, group 2 had a cholesterol reduction response from 71.4% of the subjects. In group 1, 50.0% were respondents, and 42.9% subjects in group 3 were respondents at week 4. It appeared that group 2, taking 1,000 mg three times daily, was the optimum dose in achieving cholesterol reduction effects.
Though this study is small with a small figure of subjects in each of the study groups, as well as a shorter durational period of 4 weeks, notwithstanding there was a clear effect with significant diminutions in serum cholesterol seen as early as week 2, in the 1,000 mg three times day group. Mysteriously, the respondents in group 3, receiving the highest dose (4,500 mg/day), had the smallest response to the hibiscus extract with an average of 8.3% reduction at week 4. Group 1 received a 14.4% reduction at week 4.
2. Another study in 2009, 60 Type 2 diabetics, typically women, were given either Hibiscus tea from Saudi Arabia or black tea, 1 cup twice per day. Seven individuals withdrew from the study and after one month, mean HDL cholesterol increased significantly (48.2 mg/dL to 56.1 mg/dL) whereas apolipoprotein A1 and lipoprotein (a) were not significant. There was also a significant decrease in the mean of total cholesterol (236.2 to 218.6), LDL cholesterol (137.5 to 128.5), triglycerides (246.1 to 209.2) and Apo-B100 (80.0 to 77.3) in the Hibiscus group. Only HDLc showed a significant change in the black tea group (46.2 to 52.01). Something as simple as Hibiscus tea in a diabetic, is a welcome intervention. Achieving a 7.6% decrease in total cholesterol, an 8.0% decrease in LDLc, a 14.9% decrease in triglycerides, a 3.4% decrease in Apo-B100, a 4.2% increase in Apo-A1 and a 16.7% increase in HDLc is no small accomplishment with merely two cups of tea per day.
3. Hibiscus extract was also studied in 222 patients, some with and some without metabolic syndrome (MS). A total daily dose of 100 mg Hibiscus sabdariffa extract powder (HSEP) was given for one month to men and women, 150 without MS and 72 with MS. They were randomly assigned to a preventive diet, HSEP treatment or diet combined with HSEP treatment.
The MS patients receiving HSEP had considerably reduced glucose, total cholesterol and LDL-c and increased HDL-c. A triglyceride lowering effect was seen in all groups but was only significant in the control group that was treated with diet. The triglyceride/HDL-c ratio was also significantly reduced with HSEP in the control and MS groups, indicating an improvement in insulin resistance. It has been conjectured that the anthocyanins regulate adipocyte function, which has definite and significantconsequences for both preventing and treating metabolic syndrome. Due to both its hypolipidemic and hypotensive effects, Hibiscus extract would be an excellent option for individuals with metabolic syndrome.
4. A double-blind, placebo control, randomized trial in 69 subjects with elevated LDL and no history of coronary heart disease did not appear to show a blood lipid lowering effect from Hibiscus extract. The treatment group received 1,000mg/day Hibiscus extract for 90 days in addition to dietary and physical activity. Body weight, serum LDL cholesterol and triglyceride levels decreased in both the extract and placebo groups, with no significant differences between the two. Probably the positive effects were due to dietary and exercise activity. You may be wondering why the results of this study were negative and the three previous studies above, showed positive results.
The doses and product used in all four studies were different so kindly take note on this. Someone used a tea, another used dried powdered flowers; another used a uniform extract powder of the sepals of the flowers, and this one, an ethyl alcohol/water extract, dried and then powder of the leaves. You have to take into consideration and reason that these different preparations would yield different results. So until the researchers consider to focus on more consistent product selection and dosages used in larger randomized trials, hopefully it would clarify the best approach to emulate.
5. Hypertension is an important another area indicated for the use of Hibiscus. The blood pressure lowering effects of sour tea (ST) Hibiscus sabdariffa was compared with black tea (BT) in type II diabetics with mild high blood pressure.
The studies’ Patients were randomly apportioned to drink one cup of Hibiscus or black tea two times per day for one month. The average systolic blood pressure (SBP) in the Hibiscus group decreased from 134.4 + 11.8 mm Hg at the start of the study to 112.7 + 5.7 mm Hg after 1 month. The average SBP changed from 118.6 + 14.9 to 127.3 + 8.7 mm Hg in the black tea group during the same time period. There were no statistically significant effects on the mean diastolic blood pressure in either group. This drop in systolic blood pressure is clinically relevant, decreasing systolic blood pressure in pre-hypertensive ranges, to normal systolic blood pressure. We do not know if systolic blood pressure would be lowered by one cup of Hibiscus tea in those with stage I or stage II hypertension.
6. A randomized, controlled, double-blind clinical comparison study was done of Hibiscus sabdariffa extract with lisinopril on patients with stage I or II hypertension. What you have to note is that lisinopril is a conventional medication for treating hypertension by the conventional practitioners.
In this important study, the researchers used a dried powdered Hibiscus extract delivered in 250 mg of water containing a total of 250 mg anthocyanins from Hibiscus extract for 4 weeks and the lisinopril group received 10 mg/day. Results showed that the Hibiscus extract decreased blood pressure from 146/98 mm/Hg to 130/86 mm/Hg. Blood pressure reductions were lower than with lisinopril, but the Hibiscus extract did not modify plasma potassium levels and did not have the mineralocorticoid effects. Based on the study data, the authors concluded that the Hibiscus extract did have a significant antihypertensive action, and through at least two mechanisms of action: diuretic effects likely as an aldosterone antagonist and ACE inhibitory effects. It was also reassuring to note in the study that the diuretic activity did not alter plasma potassium levels and did not have mineralocorticoid effects.
7. A Cochrane review of Hibiscus effects on blood pressure published in 2010 resulted in five articles. The reviewers included randomized controlled trials (RCTs) of 3-12 weeks in duration that compared Hibiscus to either placebo or no intervention at all. All five of these studies found significant reductions in systolic blood pressure. While they could not draw reliable conclusions about the benefit of Hibiscus for controlling or lowering blood pressure in hypertensive patients, in the articles that met their inclusion criteria, they did state that beneficial effects were found in the treatment of hypertension with Hibiscus, but that well-designed, placebo-controlled RCTs were needed.
The safety profile of Hibiscus is excellent with no proven adverse reactions. Hibiscus also has a Generally Recognized as Safe (GRAS) status.
From the research, it is difficult to clarify dosing recommendations as different products were used in different studies. This is what I now termed Allopathic Alternative Medicine” my approach now in managing my patients. For the benefits of the readers and the practitioners, this is my recommendation from the evidence based studies in your practice.
The following doses were used in each of the positive studies.
For dyslipidemia: consider 1,000 mg dried herb tid; 1 cup of tea bid or 100 mg of extract bid.
For hypertension: consider 1 cup of tea bid; dried powdered Hibiscus extract (250 mg anthocyanins) per day
For Prostate health watch out for my magic bullet formulation to hit the global market soon as you need amalgamation of all the supporting evidence based ingredients to achieve a positive response rate.
Dr. Raphael Nyarkotey Obu is a Research Professor of Prostate Cancer and Holistic Medicine –faculty of Holistic Urology, Da Vinci College of Holistic Medicine, Larnaca City, Cyprus. He is the National President of the Alternative Medical Association of Ghana (AMAG). A registered alternative Medical practitioner with specialty in orthomolecular oncology, Prostate Cancer Policy maker and researcher. He can be reached on 0541090045. E mail: [email protected]