Podcast 272: Herbalists’ Views on the Top-Selling Herbs (Part 11): Yohimbe & Horny Goat Weed
The best-seller herbal supplements we’re covering today are yohimbe & horny goat weed. They placed #30 and 31 on the list we’re using for this sequence of episodes. These two are marketed & sought-after as “male aphrodisiacs”, “testosterone boosters”, and even “herbal Viagra”. 🙄
While it’s true that each can “help” with some forms and manifestations of erectile dysfunction, in the short term or “in the moment”, they cannot correct the underlying issues… and might even make them worse.
They’re also quite potent, energetically speaking: heating, drying, and tonifying to a high degree. These qualities are primarily derived from potent constituents such as yohimbine and icariin. Each herb also possesses a multitude of other constituents apart from those more famous ones, which means its actions are diverse and in some cases self-contradictory.
There’s also a very serious problem in the supplement market for these herbs, which is that these products are frequently contaminated or adulterated. Many cases of ‘herbal’ supplements for ED have been found to contain pharmaceutical drugs. In other words, that “herbal Viagra” was actually just… Viagra. 😒
Of the two of these herbs, Epimedium is significantly safer – but to be honest, we don’t advise people to work with either of these plants. Other methods of addressing the issue at hand are more successful and more permanent, starting with herbal work to improve circulation and emotional steadiness. That’s perhaps not as exciting as “herbal Cialis”, but it’s safer and more realistic!
30. Yohimbe – Pausinystalia johimbe
- HERBAL-MEDICAL CONTRAINDICATIONS, Michael Moore
- Yohimbe at Henriette’s Herbal Homepage
- Jabir NR, Firoz CK, Zughaibi TA, Alsaadi MA, Abuzenadah AM, Al-Asmari AI, Alsaieedi A, Ahmed BA, Ramu AK, Tabrez S. A literature perspective on the pharmacological applications of yohimbine. Ann Med. 2022 Dec;54(1):2861-2875. doi: 10.1080/07853890.2022.2131330. PMID: 36263866; PMCID: PMC9590431.
31. Horny Goat Weed – Epimedium spp.
- Chen XL, Li SX, Ge T, Zhang DD, Wang HF, Wang W, Li YZ, Song XM. Epimedium Linn: A Comprehensive Review of Phytochemistry, Pharmacology, Clinical Applications and Quality Control. Chem Biodivers. 2024 Aug;21(8):e202400846. doi: 10.1002/cbdv.202400846. Epub 2024 Jul 9. PMID: 38801026.
- Cui J, Lin L, Hao F, Shi Z, Gao Y, Yang T, Yang C, Wu X, Gao R, Ru Y, Li F, Xiao C, Gao Y, Wang Y. Comprehensive review of the traditional uses and the potential benefits of epimedium folium. Front Pharmacol. 2024 Sep 11;15:1415265. doi: 10.3389/fphar.2024.1415265. PMID: 39323630; PMCID: PMC11422139.
- WHAT’S IN A NAME? Erxian Tang: Two Immortals Decoction, Subhuti Dharmananda – Erxian Tang is a famous TCM formula containing Epimeidum spp., frequently adjusted or expanded to address health complaints in the reproductive organs, kidneys, circulation, and other issues.
It’s worth emphasizing that the majority of cases of erectile dysfunction, and several other types of sexual dysfunction or performance issues, are attributable to circulatory issues rather than hormonal imbalances. If you’re looking for herbs to help with this trouble, and to address circulatory, blood, and heart health more broadly, then our course Cardiovascular Health is for you!
Like all our offerings, this online video course comes with free access to twice-weekly live Q&A sessions with us, lifetime access to current & future course material, open discussion threads integrated in each lesson, an active student community, study guides, quizzes & capstone assignments, and more.
Previous episode in this series:
- 1: Psyllium, Elderberry, Turmeric, Ashwagandha
- 2: Apple Cider Vinegar, Cranberry
- 3: Wheatgrass, Beet Root, Ginger
- 4: Green Tea, Fenugreek, Ivy Leaf
- 5: Ginkgo, Guarana, Maca
- 6: Saw Palmetto, Cinnamon, Echinacea
- 7: Tribulus, Pycnogenol, Garlic
- 8: Milk Thistle, Black Cohosh
- 9: Aloe, Flax (plus new market data!)
- 10: Valerian, Pumpkin, Goji, Red Yeast Rice
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Episode Transcript
Ryn (00:15):
Hi, I’m Ryn. And I’m here at Commonwealth Holistic Herbalism in Boston, Massachusetts. And on the internet everywhere thanks to the power of the podcast. Today we’re going to continue our series on the herbalist’s views on the top-selling herbs. This is part 11 of the series, and we’re getting on. We’re moving forward, but we’re not done yet. Today’s episode is going to be focused on two herbs with a very similar kind of reputation and a similar market presence. We’re talking today about yohimbe and about horny goat weed. As the name, as the common name for the latter herb might suggest to you, these herbs have some reputation as being an aphrodisiac, or specifically a male aphrodisiac, or as a remedy for erectile dysfunction. You’ll even sometimes see these referred to as herbal Viagra, or herbal Cialis, or something like that. And as you might guess, if you’re a regular listener, that’s not exactly accurate. But there are some literal direct connections to those pharmaceuticals, and we’re going to elucidate those for you a bit today.
Ryn (01:24):
And as is also the goal of this series, we’re going to give you, or I’m going to give you my opinions about these from the perspective of a clinical herbalist as opposed to the perspective that is presented on the packages, and the product listings on Amazon, and other such places that people encounter them. But before we get too much further, I just want to remind you that we here are not doctors. We are herbalists and holistic health educators. So, the ideas discussed in this podcast do not constitute medical advice. No state or federal authority licenses herbalists in the United States. So, these discussions are for educational purposes only. We want to remind you that good health doesn’t mean the same thing for everyone. Good health doesn’t exist as one objective standard. It’s influenced by your individual needs, experiences, and goals. So, keep in mind we’re not attempting to present a single dogmatic right way that you should adhere to. Everyone’s body is different. And so the things we’re talking about may or may not apply directly to you. But we hope they’ll give you some new information to think about and some ideas to research and to experiment with further. Finding your way to better health is your own right, and it’s your own personal responsibility. This doesn’t mean you’re alone on the journey, and it doesn’t mean that you’re to blame for your current state of health. But it does mean that the final decision when you’re considering any course of action, whether that was discussed on the internet or prescribed by a physician, that’s always your choice to make.
#30 Yohimbe: A Purported Aphrodisiac With To-Be-Expected Side Effects
Ryn (02:46):
All right, so let’s talk about yohimbe. This may be an herb that you’ve heard of already. The reputation really kind of precedes this plant. And like I said before, that reputation is usually something like male aphrodisiac, herbal Viagra. And in some contexts, you see this herb referred to as a testosterone booster. That one, even more than the other two, that’s inaccurate. Because as far as we understand the mechanisms of action of this herb and its chemistry, it doesn’t really have anything to do with testosterone per se. So yes, yohimbe, Pausinystalia yohimbe, this plant, it does increase pelvic blood flow. And noteworthy, and I want to say right up front, it does that regardless of gender. There are similarly responsive structures in the bodies of males, and females, and enbies, and people in between, and folks who are intersex, and all kinds of other things that will react in a similar way to the influence of yohimbe and its main constituent yohimbine.
Ryn (03:53):
I’m going to actually quote something from Wikipedia for you just to give a sense of what’s going on with this plant, right? And this is specifically about the constituent, the key alkaloid constituent of the plant, which is called yohimbine. So the many editors of Wikipedia working together wrote this. Yohimbine selectively blocks the presynaptic alpha-2 adrenergic receptors. Don’t worry, we’re going to make sense of this. Blockade of presynaptic alpha-2 adrenergic receptors facilitates the release of several neurotransmitters in the central and peripheral nervous system. And therefore, it also does this in the corpus cavernosum, which is a part of the penis. It’s the erectile tissue there. It facilitates release of several neurotransmitters there, such as nitric oxide and norepinephrine. Whereas nitric oxide release there in the corpus cavernosum is the major vasodilator contributing to the erectile process. And let me just interject. That means that opening up the blood vessels, allowing them to receive more blood than before, it leads to an erection, okay?
Ryn (05:00):
But on the other hand, norepinephrine is the major vasoconstrictor through stimulation of alpha-1 adrenergic receptors on the corpus cavernosum’s smooth muscle. So, what they’re essentially saying is that the actions of this constituent, this one constituent among many of this herb, which we’re going to see in a moment includes many others, is to some extent self-contradictory. You have actions to increase the release of both the nitric oxide, which is vasodilatory, opening the blood vessels, allowing more blood to enter and to remain. On the other hand, you have the activity of the norepinephrine, which would be constricting those blood vessels at the same time. Wikipedia folks go on to note under physiologic conditions however, the nitric oxide attenuates the norepinephrine vasoconstriction. And so anyway, the ultimate effect of this is that people do find it easier to achieve and to maintain an erection. Okay. So, that’s all true. We can see that there’s science about this, there’s chemistry about this, there’s physiology.
Ryn (06:01):
All right, that’s fine. But hang on. Please wait. There remain several important caveats to be made in this context, right? One of them is that when we observe the effects of yohimbe as a whole, there are what you might be inclined to refer to as side effects or adverse effects that come with this plant. And that one should not just recognize as possibilities, but one should expect, especially with larger or continued doses of the herb. So, for one thing, yohimbe, the plant, can increase aggression. It can increase agitation. And it can increase anxiety. If you think about those energetically, if you think about them in terms of patterns the way that herbalists do, you’re going to recognize all of those as heat signs. Signs of elevated heat, activation, stimulation, reaching into realms of overstimulation, overactivation, right? That’s where you feel unable to settle. You feel more anxious. You feel more reactive, or your temper is going to flare more rapidly, okay? And so yohimbe can cause all of those things. And like I said, with larger doses, with extended use, we should expect that those things may occur. At the same time, this plant can also aggravate states of dryness and of tension in the body. So, this is a hot or a heating, a drying, and a tonifying herb on our energetic assessment of the plant, those primary qualities, right? And it’s potent in all of those regards, okay? This is not like mildly warming the way something like fennel seed is. It’s not mildly tonifying the way like St. John’s wort would be. This is exerting all those energetic effects in strong ways largely because of the high concentration of alkaloids that are present in the plant.
Boosts Circulation, Not Testosterone & Indole Alkaloids
Ryn (07:51):
All right. Now, it’s also worth saying that based on current, best scientific understanding of this herb and its chemistry, this is not going to boost testosterone. That is simply not part of its function, not part of how it achieves what it does. People believe that it does solely because of its application in erectile dysfunction. The thinking is essentially more erections equals more testosterone. But this is not what’s actually in play here, all right? The problem that yohimbe, quote-unquote, helps with is about circulation, right? The effects of that chemical on those messengers that are influencing vasoconstriction, vasodilation, and the balance between them. That’s what this herb is doing. It’s not influencing your capacity to do that thing through a hormonal effect, but people believe that it is. And you will see a lot of advertisements, a lot of marketing, a lot of product claims and so on about yohimbe and formulas that include it that are promoting it as a testosterone booster. It’s simply not true, okay?
Ryn (09:01):
About yohimbine again, right? Yohimbine is an alkaloid. It’s in this group called the indole alkaloids. It’s the most famous constituent of the plant, and it has affinity for a number of different receptors in your body and in your central nervous system. And as we just saw a moment ago in erectile tissue and other places throughout the system, right? It’s not only going to act in the pelvic region, okay? It’s going to act throughout your entire body. And it’s going to be binding to adrenergic receptors, serotonin receptors, and also dopamine receptors. This is considered what they call a sympathomimetic agent, which is to say that it acts in a similar way to things that would trigger the sympathetic nervous system. Recall that the sympathetic nervous system is highly activated in states that we refer to as fight and flight, okay?
Ryn (09:53):
When it’s more mildly activated, that’s what we would call alert or aware, right? So, we’re on that side of the spectrum, which terminates on one side with fight or flight, terminates on the other side with rest and digest. And there’s this whole spectrum in between where we find ourselves moving back and forth as we go through our day and experience and encounter different things. Yohimbe has also in a few contexts been referred to as vasopressor mimetic. So, this is just saying that it has an action similar to the hormone vasopressin, which again is involved in the constriction of blood vessels and therefore the flow of blood throughout the body. Okay. But like I’ve been saying, yohimbe is more than just the one chemical. It’s more than only yohimbine. And I’m going to bring in some, some words from the famous and dearly departed herbalist, Michael Moore. Not the film director, okay, but a different dude. And he had some really excellent comments on yohimbe that I felt I had to share with you all today, right? So, he referred to this plant as quote, an indole stew due to its content of yohimbine as well as a number of reserpine alkaloid relatives. And pointed out that there’s more than 50 different indole category alkaloids to be found in this plant. It’s worth noting because basically every alkaloid is likely to be a strong actor. Those that are in the indole alkaloid group are even more likely to be a strong actor on our nervous system, on our physiology. And so this is going to have, again, numerous effects, not just the single one.
Ryn (11:25):
Michael Moore further included this plant in his list of herbs lacking any socially redeeming value, all capitals, right? And he described it as follows. He said it’s an especially pernicious herb with simultaneous sympathetic and parasympathetic actions. It will mimic vasopressin and can irritate the kidneys. It increases pelvic blood supply and can aggravate reproductive, genitourinary, and descending colon irritations. It can irritate arterial endothelium and contribute to or cause vasculitis. Lousy for the prostate. It can trigger a few and relatively useless erections followed by rebound re-flaccidity. I think that quote pretty much speaks for itself, right? He’s emphasizing some of the problems I’ve mentioned already. I think adding in this context that it’s problematic not just for the prostate, but also other organs of the pelvic region beyond those involved in reproduction. I think that’s a really worthy note. And you can certainly imagine people who would have multiple different health issues in this region of the body or others looking for a solution for an erectile problem, choosing this herb, and then aggravating other existing health conditions or possibly even generating them. So yeah, significant issues there.
Ryn (12:50):
In another context- and I’ll put the link to these in the show notes, of course, right? – but in another context, Michael Moore also wrote let’s be clear here. The alkaloid yohimbine is not an MAO inhibitor, but the Herb yohimbe is. This is an important note in the context of herb-drug interactions. And it’s noteworthy because yohimbine being itself has been studied fairly extensively in the pharmaceutical and chemical world. And sometimes there’s this confusion about whether yohimbe or yohimbine products can or should ever be taken safely in combination with an MAO-inhibiting drug or a drug that’s metabolized by that monoamine oxidase enzyme that’s under discussion there. And so it basically points out that there can be a significant differential of safety and interaction risk between the isolated compound being studied in medical contexts and the whole herb, or a homemade product, or a preparation of it.
Ryn (13:51):
This is a case in which at least in that specific context of an MAOI herb-drug interaction situation where the isolate might actually be a little bit safer. Let’s not go too far with that but okay. Michael Moore also had another comment here, and this is mainly for color, right? But he says the whole plant is potentially so evil and insidious because its complex chemistry contains both adrenergics and cholinergics with effects that substantially mimic both sympathetic adrenergic, sympathetic cholinergic, and parasympathetic neuroreceptors all at the same time. It contains both yohimbine alkaloid groups, stimulating and hypertensive, and several potent reserpinoid alkaloids like those found in Rauvolfia serpentina, which are tranquilizing and hypotensive. Summing this up he calls it a warlock’s brew. A difficult plant to work with safely. Oh, yeah. And then he had one other comment kind of talking about chinks in the armor. Saying consistent use will, because of these wildly opposite effects, find and widen metabolic chinks in the armor for almost anybody.
Safety, Adulteration, & Product Inconsistencies
Ryn (15:04):
Yeah. So, it’s not a super positive review so far of this plant. But as always when we’re talking about these herbs, we want to think about safety. We want to think about applicability. We can look at our old trusty Botanical Safety Handbook and see what they have to say about it. So the Botanical Safety Handbook says of yohimbe, not for use in persons with liver or kidney diseases or in chronic inflammation of the sexual organs or the prostate gland. Again, think of somebody who’s dealing with the effects of a swollen prostate, benign prostatic hyperplasia, prostatitis, even something as extreme as prostate cancer. It’s not unusual at all for them to have difficulty with erectile activity. If they then go, and they hear somebody say well, here’s an all-natural herb that you can take for your ED. And it must be safe, right, because it’s natural. Well, you can see where this could lead people into trouble. And this is a common sequence of events to occur. The BSH reports multiple case reports of significant injury and even death associated with yohimbe products. And so we have to be very, very, very picky, very, very cautious if anybody’s ever going to work with those, right? Not only because of the herb itself, but I would also mention that this herb maybe more than any other. That might be going really far, but let’s say this herb or this category of plants for sexual potency, that kind of thing, is very, very prone to adulteration with pharmaceutical agents. So, for example, with Viagra, sildenafil, Cialis, or in some cases with other species of plants.
Ryn (16:44):
And what you kind of get in that context is a divergence, right? On the one hand, if your supposedly herbal Viagra is actually just Viagra, then yeah, you’re now consuming a pharmaceutical when you thought you were consuming an herbal. And many potentialities for unsafe interaction and adverse events are going to arise from that. There are some cases where the adulteration of the Yohimbe is being done with a different species. And in some cases that might actually make it safer, right? Because those other species would be less active or less pharmacologically complex in comparison to yohimbe. But we can’t count on that, right? We have to assume that a low-quality product, an untrusted brand, somebody trying to make a quick buck on Amazon or wherever is not trustworthy and not a safe thing to consume. Just because of the very frequent rate of adulteration and/or contamination associated with this specific herb and with the whole category of herbs for quote-unquote sexual health, or potency, or things along that line.
Ryn (17:53):
Even in products that are derived from the actual plant material, high levels of variability have been found in their yohimbine content. So, quoting again from the Botanical Safety Handbook, in a study of 49 dietary supplements labeled as containing yohimbe, 78% of the labels did not list the quantity of yohimbine at all. So, there was no real comparison to make, right? Of the 11 that did provide the quantity of yohimbine that should be in the product, the actual content ranged from 23% to 147% of the labeled content. So, maybe you were being super on point. You were like I’m educated about plants and chemistry. I understand that the real risk is coming from this key alkaloid in there. And that there’s a safe range of numbers of milligrams of that that I can consume in a given day. I chose this product because it told me a specific amount that I was going to be receiving. And I feel like I could take my dose, and I could get that into a safe range.
Ryn (18:55):
But then maybe you’re taking less than a quarter of what you thought you were. Or maybe you’re taking one and a half times as much of what you thought you were, right? And so this is not a problem unique to yohimbine or yohimbe products. But it’s particularly acute when you have something with that degree of potency carried within the herb in question. And so this is a much greater concern for me than say, a hawthorn product that had a 23% to 147% variation in the amount of bioflavonoid content, right? That wouldn’t be harmful. You would lose some benefit if it was too much lower. You might get a little more benefit if it was higher. But in either case it’s not dangerous to you. In the case of yohimbe, it could be, right? The BSH also commented that prior studies around yohimbine supplements found them to contain from 0%, nothing, to 368%, four times as much nearly of the labeled quantity of the yohimbine, right? So, again, just a high degree of variance from product to product, maybe even from batch to batch.
Ryn (20:01):
All right. A couple other cautions. As I mentioned before, it may be very dangerous to combine yohimbe or yohimbe extracts with an MAOI drug, or we can add with any drug that interacts with MAOI drugs, okay? Now we’re starting to build a significant list. And then more broadly, this is just not a good herb for anybody with high blood pressure, with high heart rate, with a swollen prostate, with liver and kidney problems. And again, most of these are not at all unusual comorbidities in somebody who’s coping with erectile dysfunction. They tend to travel together. And so what you usually get is more reasons not to take it than you have to try it. The other key thing here is to say that there are other safer herbs and broader holistic strategies which can address these same complaints. And can do it in a way that’s going to get to the root cause and going to resolve it in a more permanent lasting manner. So, I don’t recommend yohimbe to anybody. And if I ever have clients who come in and say that they’re working with it now and then, I steer them away, right? I steer them away from that. I would suggest other things instead.
#31 Horny Goat Weed: Similar to Yohimbe With A Better Safety Profile
Ryn (21:15):
Okay. So, let’s move on to our next herb today. This was number 31 on the bestsellers list. This is horny goat weed. This is a variety of species in the genus Epimedium. So this one, I had a few things I learned actually as I was digging into this further for this episode. So, let’s start out with basic energetics. Similar to yohimbe, horny goat weed is also going to be a heating, drying, and tonifying agent. This is one that does have a long history of people working with it in Chinese medicine and traditional Chinese medicine. And in that context, this is regarded specifically as a yang tonic herb with a particular affinity for kidney yang energies. We can sort of translate that concept and say this is about, again, stimulation, heat, activation, movement from the inner to the outer, movement from the lower to the higher. These kinds of things are what’s associated with those terms. The sort of mythological origins of this plant as a human herb are similar to actually what you might hear about coffee and how did people start working with that? So, in this case it is said that a goat herder noticed that his herd became very sexually active after grazing in a field of Epimedium. And the goat herder then tried a tea made from it with satisfactory results, right?
Ryn (22:47):
So again, in this case, and I think this is a bit different from the yohimbe plant, there is a traditional context in which people are doing it. But it’s also worth saying that it wouldn’t be restricted to those actions at all. As far as species go, it’s primarily Epimedium grandiflorum in supplement products and also other Chinese region species as well. I’ll have a little comment to say about some western European Epimedium species at the very end here. But it’s primarily going to be the East Asian, the Chinese species that people are talking about. And especially in product manufacture, it’s usually going to be the grandiflorum. The most famous constituent in here is called icariin. That’s I-C-A-R-I-I-N, icariin. And that is quote, a weak PDE5 inhibitor, which has a vasodilatory effect. So, PDE-5 inhibition is the same mechanism of action for Viagra and for Cialis, right? Or if you want their fancy names, sildenafil and tadalafil, right? So, really it’s that -afil group of pharmaceutical drugs, the whole class of them that has this activity of inhibiting the action of PDE5.
Ryn (24:10):
What that does is essentially induce greater vasodilation, the opening of the blood vessels. And again, this doesn’t only happen in the pelvic organs or only happen in the penis. This happens throughout the body. And because of that, those drugs and agents that act like them such as icariin, they can exert some degree of bronchodilator effect and some dilation of peripheral blood vessels as well. So, there are contexts in which somebody with what’s called Raynaud’s syndrome, where they have constricted blood vessels in their periphery and poor blood flow to the hands and feet. In some cases, those folks are given sildenafil, or tadalafil, or a related drug to help with circulation, right, not because of any erectile problems they may or may not be having. So, just to say even in the pharmaceutical version, even in that one isolated alkaloid context of the chemical there, that it’s broader than just pelvic activity or sexual activity. All right.
Ryn (25:19):
Now, because of the similarities of these two herbs – the heating, drying, tonifying effects – many of the caveats that I raised about yohimbe can also apply to Epimedium, right? You could overstimulate someone. You could dry them out. You could overtight their connective tissues, their mucous membranes, things like that. That can all happen with both of these plants. But I do have to admit that this herb, Epimedium, horny goat weed here has a significantly better safety profile in comparison to Yohimbe. So the Botanical Safety Handbook rates horny goat weed as class one A. Which is to say that it has a low risk of generating its own adverse events in the context of all available herbs, right? And it has a low risk of drug interactions as well. Yohimbe by contrast is rated 2B/C/D. So, B, C and D are different categories of safety warning having to do with existing conditions, special populations, pregnancy, and such. And then the two, the rating of one or two or three, is the risk of drug interaction. So, anyway, 1A versus 2B/C/D, you can see that the Epimedium has a significantly better safety profile than the Pausinystalia. All right.
Ryn (26:44):
That said, it’s still not in the clear. Because horny goat weed may have negative impacts on kidney function. And that can show up even in a blood test in your blood serum levels of creatine and creatinine. Those are basically going to get elevated when there’s more stress, more strain on the kidneys. Rat studies have indicated potential for liver, pancreas, and more broadly speaking, metabolic damage and dysregulation when they were being given extracts of this plant. In humans, there are case reports of agitation, elevated heart rate, insomnia, gastrointestinal distress, right? Cramping, discomfort in the belly, that kind of thing. These are all similar to yohimbe, but not as severe, right? One could say if you were to give the same dose of yohimbe versus horny goat weed to the same person, in both cases you’re going to expect their heart rate to go up, for them to get more agitated, maybe anxious, maybe angry. But that it would be more pronounced with the yohimbe, all right? Not zero for horny goat weed, but not quite as dangerous. And of course, as always there’s going to be greater risk in somebody who’s taking multiple medications or has multiple existing health conditions.
Adulteration, Different Applications, & Species
Ryn (28:05):
There are, again, issues of adulteration and contamination in supplement products made from horny goat weed simply because of the category, simply because of the demand. Because of the potential to make some money selling some cheap stuff and telling people that this is what it is. Remember the mantra here. Always be highly suspicious of supplements sold for weight loss, energy, or sexual function or impotence. All right? Just always highly suspicious of those categories because they’re the most likely categories to be adulterated, to be contaminated, to deceive you, or to otherwise cause problems. Again, this could include pharmaceutical adulteration with sildenafil or tadalafil – Viagra, Cialis – but also with related chemicals that were never approved by any agency as medical drugs. So, these are sometimes referred to as designer drugs. And essentially it’s somebody who is capable of doing some serious chemistry and is able to make a compound that’s similar in structure to one of those FDA-approved medications but not quite exactly the same. Sneak that into their product. It might evade certain detection mechanisms. But these kind of things have been found in these kind of supposedly herbal supplements that people are out there buying, right?
Ryn (29:29):
There are a few other odd things that I came across. And there’s a particularly interesting case report where what happened was there was a 62-year-old man who had been in remission from opioid addiction. And he had been in remission for 10 years. He was with medication assistance. He was taking buprenorphine and naloxone every day to enable him to avoid seeking out opiates or opioids or consuming them. And he started taking horny goat weed products, and he started to experience worsening cravings for opioids. He was like I know this feeling. It’s getting worse. And he went in to talk to doctors about it, and it seemed to correlate with the introduction of taking that Epimedium supplement. There was no clarity in that case report about which product it was or what kind of dose he was taking. We are not sure if it could have been contaminated or adulterated with another medication or something like that. But nothing else had changed for him. His opioid treatment regimen, psychotropic medications he’d been taking for bipolar disease and other things like that, that was all steady.
Ryn (30:43):
It wasn’t relapse. They did a drug screening on him, and they were like nope. You didn’t start taking some opioids, or sneakily get them somehow, or whatever. But they did find this, right? And what they ended up doing was increasing the buprenorphine and the naloxone to try to reduce those cravings for him again. But this was a very odd and unusual kind of a drug interaction. And, you know, it’s one that caught my attention simply because of the frequency and the commonality with which people are consuming opioid drugs and struggling with them. I would certainly never want to have somebody who was looking for help. Somebody who was in recovery, in remission and looking for help with a sexual function problem. And then suddenly give them really bad cravings and then send them seeking. That would be really, really bad. So, we would definitely want to avoid it in that context and with that in the person’s health history at all.
Ryn (31:44):
As always, we can remind ourselves that every herb has more than one application. All right? And so like I said, in traditional Chinese medicine this herb has a number of different applications, many of which don’t have anything to do with sex or sexual function. Recent pharmacological reviews of the plant have said, for instance, studies have shown that Epimedium has osteoprotective – bone health, okay – neuroprotective, and cardioprotective activity, as well as some capacity to enhance immune function within the body. There was another one that found it helpful in safeguarding the reproductive system, promoting bone health, mitigating inflammation, and combating tumors and viral infections. In traditional Chinese medicine terms, the applications for this plant go far beyond reproductive health issues and get into this broader realm of what you would call kidney yang tonification, right? So, emphasizing that particular type of energy in that particular system or set of functions in the body, that’s the way that it would be thought about. And that’s again, much, much broader than just reproductive questions.
Ryn (32:54):
One of the links I’m going to include in the show notes for you. I’ve got two about these kind of reviews of the plant, and traditional and modern applications for it, and its chemistry. And then there’s one here, the link is called What’s in a Name? Erxian Tang: Two Immortals Decoction. So, erxian tang – and forgive my pronunciation if you actually do it right. – this is a famous traditional Chinese medicine formula that contains Epimedium species. And it’s often adjusted or like expanded, like add more herbs to the formula for an individual person, to address health complaints sometimes in the reproductive organs, often in the kidneys, often in circulation more broadly, and other issues as well, right? So, this particular episode, this series, we’re focusing on commercial presentations, and the kind of things you’re going to see on the product listing on the website, or in the store, or whatever. But I did just want to make it clear that there are significantly broader concepts about this plant in traditional medicine and in modern investigations as well. Okay.
Ryn (33:54):
One final note for today, there are a few European species of Epimedium. For instance, Epimedium alpinum is a western European species of it. In English language, many of these species were known as barrenwort. Barrenwort, okay? Like St. John’s wort or mugwort, WORT. So, this one is barrenwort. They had some other names as well, but that one was fairly common. And it was probably to do with where the plant grows in soil that other plants don’t really like or don’t really thrive in, right? So, it would be the wort that grows in the otherwise barren soil. I found an interesting quote. This is from an early 19th century English author. This is John Hill in the book, The Family Herbal. This was published in 1812. And in there was a writing about barrenwort. A quote here: The people in the north give milk in which the roots have been boiled to the females of the domestic animals when they are running after the males. And they say it has the certain effect of stopping the natural emotions. Plain sense leads these sort of people to do many things. They have from this been taught to give it to young women of robust habits subject to violent hysteric complaints. And I’m assured with great success. They give the decoction of the root made strong and sweetened. Twas a coarse illusion that led them to the practice. But it succeeds in cases that foil all the parade of common practice. It is said that if they take it in too large quantity, it renders them stupid for some hours. But no ill consequence has attended this.
Ryn (35:43):
Man. Sometimes you read these older herbal authors, and you just get a sense of a different kind of person. Anyway, it’s kind of hard to say if what they’re describing here is an indication of an anaphrodisiac, like an anti-aphrodisiac effect of this European species of Epimedium in comparison to the Chinese species. Or whether it indicates something else entirely, or we’re not really sure. So, I shared that in part just to point out that this could be one of those cases where you get really different effects from one species versus another species in the same genus of plant. Or it could be that the way people think about and respond to these patterns has really changed very significantly over time. In some sense, it kind of reminds me of the way that people around that era and earlier would’ve looked at vitex as an herb suppressive to sexual function and especially sexual urges. Whereas today it’s not unusual for people to be like oh, you’re having trouble with reproductive health? You should take vitex. And you know, that’s a whole other topic. But I’ll just say blech, okay? But, you know, anyway, the interest here today is just like variation in the way people think about these plants over time. Sometimes a total 180 degrees swing or potentially a big difference between one species versus another. And so it’s another call for us to give some respect to the botanists and the taxonomies for helping us to maintain some clarity about those things.
Ryn (37:20):
Yeah. All right. That’s going to be it for today. If this was interesting to you, if you’re a new listener, then welcome. And I want to make sure you know that we’re not just a podcast, we’re also an herbal school. And you can learn from us online at your own pace. And we can teach you everything you need to know about herbalism from the very beginning, all the way up until you’re ready for full-on clinical practice and mentorship. You can find everything we offer at online.commonwealthherbs.com, and I hope to see you there soon. Until then, take care of yourselves. Take care of each other. And look, if you’re having erectile dysfunction problems, let’s start with more walking and more pelvic floor stretching, and squatting, and lunging movements. And let’s also start talking about stress, and anxiety, and tension. Because in our clinical experience, working on circulation and emotional state tends to be the most effective way to resolve this problem. So, let’s do all of that before we go reaching for the yohimbe or the horny goat weed. All right. Until next time, thank you.
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