Chaste Tree - Medicinal Uses, Interactions, Side Effects, Dosage
by: prasinsec
Total views: 246
Word Count: 1162
<p><strong>Chaste Tree </strong></p>
<p>The dried fruit or berry of the chaste tree is often referred to as Monk's pepper or chasteberry; it was historically thought to reduce libido or promote chastity. Chaste tree is also commonly referred to as vitex. </p>
<p><strong>Uses and Benefits: </strong> </p>
<p>Standardized extracts of the chaste tree berry are popular in Europe, and now in North America, for a variety of women's problems primarily related to the menstrual cycle. These disorders include menstrual cycle irregularities, the premenstrual syndrome (PMS), cyclic breast pain, dysfunctional uterine bleeding, and infertility. Historically, vitex has also been used for inflammatory conditions, diarrhea, flatulence, insufficient lactation, and menstruation induction. </p>
<p><strong>Pharmacology: </strong></p>
<p>The major herbal constituents of the berry in­clude terpenoids (e.g., vitexilactone), flavonoids (e.g., casticin), iridoid glycosides (e.g., agnuside and aucubin), and a volatile oi1. Small amounts of compounds related to androgenic steroids have been reported to be isolated from leaves and flowers,5 but these plant parts generally are not used medicinally. </p>
<p>Studied primarily in Germany since the 1950s, hydro-alcoholic extracts of the herb have well-established central dopaminergic activity <em>in vitro </em>and <em>in vivo </em>(binding to dopamine 2 receptors), which inhibits pituitary prolactin secretion in animal studies.1,2,6-8 Although traditionally used to increase lactation, large doses in lactating rats significantly reduced milk production in one study, presumably due to the drop in prolactin secretion. 4 Effects on pro­lactin in humans are complex and not well elucidated. While some studies demonstrate mild reductions in prolactin secretion (or pro­lactin levels), some show no changes or even increases. Opioid and estrogen receptors are also bound <em>in vitro,</em>although the strogenic effect is significantly weaker than other known phyto­(~strogens (e.g., red clover isoflavones).</p>
<p>Several European trials suggest that vitex corrects deficient progesterone levels in women with "corpus luteum insufficiency" or "latent hyperprolactinemia," in which low progesterone levels predominate in the 2nd (luteal) phase of the menstrual cycle.mechanism of this effect is thought to be due to a reduction of prolactin secretion (especially in women with an absolute or relative hyperprolactinemia) or by an enhanced release of pitu­itary gonadotrophins. However, the actual pharmacologic activity IS not well characterized. Clinical trials have not found consistent effects on progesterone and/or prolactin levels, and have found no effect on gonadotropins.</p>
<p><strong>Clinical Trials:</strong></p>
<p>Vitex has been reported to correct symptoms of menstrual and related disorders in over 30 European clinical trials during the last 50 years. Beneficial effects have been de­scribed for patients with PMS, mastalgia, irregular menstrual cycles, dysfunctional uterine bleeding, infertility, decreased lacta­tion, and acne. 1 - 3 Most of these studies are uncontrolled or un­blinded, including many large post-market surveillance studies. In this review, only double-blind randomized controlled trials (RCTs) are described; several are only available in German-language journals, and are reviewed in secondary sources.</p>
<p>. Premenstrual Syndrome-Three double-blind RCTs, each lasting 3 months (or three menstrual cycles), have evaluated differ­ent vitex preparations for the symptoms of PMS. In one trial using 1800 mg/day of powdered vitex tablets, little difference was found between the vitex and placebo groups in the 217 women complet­ing the trial. The other two RCTs used standardized European commercial extract products. In 175 women, 4 mg/day of a vitex preparation (Agnolyte) was similar in effect to 200 mg/day of vita­min B6 (both decreased symptoms by almost 50%); however, there was no placebo control. 16 In a recent RCT of 178 women using 20 mg/day of an extract product (Ze440), a significantly better response rate (> 50% reduction of symptoms) was demon­strated in the vitex vs. the placebo group (52% vs. 24%, respec­tively). Self-assessment of symptoms also improved significantly on a validated symptom scale compared to placebo (P < <em>0.001).</em></p>
<p> Cyclic Breast Pain-Cyclic mastalgia is often associated with the PMS complex of symptoms. Three double-blind, controlled trials have reported beneficial results with a standardized European preparation, Mastodynon (vitex combined with several homeopathic herbs), using drops and/or tablets. In a trial of 160 women with premenstrual mastalgia, vitex was reported to pro­vide good symptomatic relief more often than placebo (74.5% vs. 36.8%, respectively), and was equivalent to a progestational agent, Iynestranol (82.1 %).18 Two similar RCTs, each lasting three menstrual cycles (n = 97 and 104 women), also reported almost identical, statistically significant reductions in symptoms com­pared to placebo.</p>
<p> Other-A double-blind RCT of 96 infertile women (66 were available at the final analysis) found that 30 drops of Mastodynon b.i.d. for 3 months was associated with twice the number of preg­nancies (21 %) compared to placebo (10%). These results were not statistically significant. Controlled trials have reported bene­fits for insufficient lactation and for acne,1 but these older stud­ies were not adequately randomized, controlled, or blinded. </p>
<p><strong>Adverse Effects:</strong></p>
<p>Vitex appears to be very well tolerated. Reported side effects in the clinical studies are rare and transient (often similar in frequency to placebo), and primarily include mild gastrointestinal complaints, allergic reactions, or headaches. A single case of unexplained nocturnal seizures in a patient taking chaste tree berry, black cohosh, and evening primrose oil has been reported ; a cause-and-effect relationship with vitex is doubtful. </p>
<p><strong>Side Effects and Interactions:</strong> </p>
<p>There are no reported interactions with vitex. Due to its potential effects on dopamine and prolactin, it is relatively contraindicated with other drugs that are dopamine agonists or antagonists (e.g., bromocriptine, metoclopramide, antiParkinson's drugs). </p>
<p><strong>Cautions:</strong></p>
<p>Use during pregnancy and lactation should generally be avoided, although vitex has been employed to enhance fertility and stimulate lactation. In a case report of a woman undergoing unstimulated <em>in vitro </em>fertilization treatment, a combination herbal preparation containing <em>vitex </em>was associated with folliculogenesis and increased FSH, LH, and progesterone <em>levels. </em>In addition, the patient complained of symptoms suggestive of mild ovarian hyperstimulation syndrome.</p>
<p><strong>Preparations </strong><strong>& </strong><strong>Doses:</strong></p>
<p>Vitex preparations and doses vary considerably; only the standardized European products <em>have </em>been demonstrated to be <em>effective. </em>In the German clinical trials, small doses of standardized extract preparations (Agnolyte, Mastodynon, and Straton) are equivalent to about 30-40 mg of dried or crude herb, and are usually administered each morning. Agnolyte is marketed in the U.S. as Femaprin (Nature's Way), and is usually qiven as one 4-mg tablet or 40 drops of extract per day. Herbalists in Britain and other English-speaking countries tend to use much larger doses of noncommercial preparations, equivalent to about 500-2000 mg/day of dried herb, often in liquid extracts and tinctures. A more recent European product (Ze 440; available as a 20-mg extract) is equivalent to about 120-240 mg of crude herb. </p>
<p><strong>Summary Evaluation </strong></p>
<p>Vitex may affect the endocrine and reproductive systems by decreasing prolactin <em>via </em>dopaminergic stimulation, although these pharmacologic properties are not fully characterized in humans. Uncontrolled trials and decades of use in Europe suggest beneficial effects for a wide variety of menstrual-related disorders. Well­designed, randomized, controlled trials are limited, but do support beneficial effects for the treatment of PMS (one trial) and cyclic mastalgia (three trials). Because <em>vitex </em>appears safe and well tolerated, and there are few <em>effective </em>treatments for these conditions, it is reasonable for women with these disorders to <em>give vitex </em>a therapeutic trial. There is insufficient evidence to make recom­mendations for other indications. </p>
About the Author
Steve Mathew is a writer, who writes many great articles on <a href="http://www.health-care-tips.org/herbal-medicines/index.htm">herbal medicines </a> and ayurvedic medicines for common ailments and diseases. Visit us for more information on <a href="http://www.home-remedies.info/herbal-remedies/index.htm">herbal remedies</a>and <a href="http://www.ayurvedic-medicines.org">ayurvedic medicines</a>
Rating: Not yet rated