Licorice Root for Cancer, Inflammation, Immune Boosting and Expectorant Qualities

Licorice Root for Cancer and Inflammation

Licorice Root Boost the Immune System

Licorice Root for Expectorant Effect

Hundreds of potentially healing substances have been identified in licorice as well, including compounds called flavonoids and various plant estrogens (phytoestrogens). The herb's key therapeutic compound, glycyrrhizin (which is 50 times sweeter than sugar) exerts numerous beneficial effects on the body, making licorice a valuable herb for treating a host of ailments. It seems to prevent the breakdown of adrenal hormones such as cortisol (the body's primary stress-fighting adrenal hormone), making these hormones more available to the body.

It has a well-documented reputation for healing ulcers. It can lower stomach acid levels, relieve heartburn and indigestion and acts as a mild laxative.

It can also be used for irritation, inflammation and spasm in the digestive tract. Through its beneficial action on the liver, it increases bile flow and lowers cholesterol levels.

Licorice also appears to enhance immunity by boosting levels of interferon, a key immune system chemical that fights off attacking viruses. It also contains powerful antioxidants. Glycyrrhizinic acid also seems to stop the growth of many bacteria and of viruses such as influenza A.

In the respiratory system it has a similarly soothing and healing action, reducing irritation and inflammation and has an expectorant effect, useful in irritating coughs, asthma and chest infections.

It has an aspirin-like action and is helpful in relieving fevers and soothing pain such as headaches. Its anti-allergenic effect is very useful for hay fever, allergic rhinitis, conjunctivitis and bronchial asthma. Possibly by its action on the adrenal glands, licorice has the ability to improve resistance to stress. It should be thought of during times of both physical and emotional stress, after surgery or during convalescence, or when feeling tired and run down.

Licorice with glycyrrhizin may help to:

Control respiratory problems and sore throat. Licorice eases congestion and coughing by helping to loosen and thin mucus in airways; this makes a cough more "productive," bringing up phlegm and other mucus bits. Licorice also helps to relax bronchial spasms. The herb also soothes soreness in the throat and fights viruses that cause respiratory illnesses and an overproduction of mucus.

Lessen symptoms of chronic fatigue syndrome and fibromyalgia. By enhancing cortisol activity, glycyrrhizin helps to increase energy, ease stress and reduce the symptoms of ailments sensitive to cortisol levels, such as chronic fatigue syndrome, cancer, and fibromylagia.

Such “miracle remedies” allow us to temporarily push disease from consciousness during times when complete healing seems out of practical or philosophical reach. However, when opting to alleviate your dog’s pain and suffering, it is important to realize that suppression of symptoms will seldom constitute a complete cure – especially when the effectiveness of an anti-inflammatory or analgesic drug prompts us to forget the real problems. Of course, our decisions to use such remedies are based largely on personal freedom of choice.

But what about our animals? They don’t enjoy such freedom of choice. Instead they must rely upon us to make weighty decisions on their behalf, and as caring guardians who are tormented by the sight of a suffering companion, we sometimes find ourselves with the difficult choice of providing comfort over cure.

Of course we wish for our companion animals to have a long, healthy life, without the liver-damaging effects of anti-inflammatory drug therapies or the immunosuppressive results of corticosteroid drugs – but we also wish for them to be comfortable.

Fortunately, there are a few herbs that stand out from all others in their ability to address both sides of this difficult issue. Some herbs can provide not only a holistic therapeutic approach, but also a measure of comfort and relief during periods of crisis. In fact, one of the best of these “near-miracle herbs” is easy to find, grows like a weed, and tastes like candy.

I am referring to the Glycyrrhizza species, licorice, an ancient medicine with a multitude of modern applications.

Healing history
The ethnobotanical use of licorice dates back thousands of years, and its history in veterinary applications is probably just as ancient. In Europe it has been considered a valued medicine and trade commodity for at least a thousand years. By the 13th century licorice was already being cultivated for international trade. And in China, licorice is still used in more applications than any other herb – even more than ginseng.

Licorice root is useful for maladies ranging from stomach upset and ulcers to the treatment of cancer. And unlike many botanical medicines that are seen by science as anecdotal curiosities, contemporary herbalists and modern researchers continue to validate the effectiveness of licorice with modern science. Literal libraries of information have been compiled on the attributes of Glycyrrhizza – and it appears that we have only begun to scratch the surface of what this wonderful herb has to offer.

Anti-inflammatory action
Most people who have taken their animals to a conventional veterinarian for treatment of a chronic inflammatory disorder have witnessed the bittersweet use of hydrocortisone and other corticosteroid drugs (such as prednisone). In many ways these drugs are close to “miracle medicines” in their ability to relieve inflammation, itchiness, and even the symptoms of cancer and nervous diseases.

But almost as quickly as we embrace the wonders of steroid therapies we are forced to recognize that they are seldom a “cure” for anything. The side effects associated with steroid drugs may be worse that the disease we wish to combat; almost immediately we can expect to see acute water retention and weight gain, and as time passes (often within two weeks), side effects may also include hypertension, altered mood and personality, heart attack, osteoporosis, and chronic illness due to depressed immune function. In many cases, antibiotics, strong diuretics, and mineral supplements become necessary just to antidote the corticosteroids.

To illustrate the implications of corticosteroid therapies all we need to do is look at how cortisone-like drugs actually work: they suppress the immune system functions and inflammatory responses that are responsible for an animal’s discomfort. By decreasing natural production of lymphocytes and antibodies, and by altering normal defensive functions of the body, corticosteroids can often make disease symptoms disappear very quickly. However, continued use of corticosteroids will eventually induce a serious state of immune deficiency that can be very difficult to reverse, and can even be fatal.


One of the problems with treating lick
granulomas is that dogs will inevitably
ingest any topical preparation you use.
This isn’t a problem with licorice.

Fortunately, licorice root may provide us with some safer options. Several studies have confirmed its usefulness as an effective, fast-acting, anti-inflammatory agent. In fact, many holistic practitioners use licorice as a substitute for anti-inflammatory drugs or to reduce an animal’s need for cortico-steroids.

The anti-inflammatory activity of licorice root is primarily attributable to a chemical called “glycyrrhizin” present in the plant. Glycyrrhizin is similar to the natural cortisone that is released by the body’s adrenal glands. Glycyrrhizin effectively stimulates the adrenals into action, while introducing its own anti-inflammatory, anti-microbial, immune-supporting corticosteroid-like actions to the body. As a result, licorice helps relieve pain, itching, and inflammation without completely bypassing normal anti-inflammatory functions, and without seriously compromising the immune system.

All of this makes licorice useful against a wide variety of inflammatory diseases. In a study where arthritis was induced into rats through injections of formaldehyde (I know this is terrible!), a by-product of glycyrrhizin called glycyrretic acid was produced in the body and was shown to have obvious anti-arthritic actions that are comparable to those of hydrocortisone.

Glycyrrhizin has also been shown to potentiate the effects of cortisone-like drugs in the body. This makes the herb a useful adjunct in corticosteroid therapies, as the drug-strengthening effect of licorice will allow for lower drug dosages without comprising therapeutic effectiveness. When used in this capacity licorice may help reduce the debilitating side effects of steroid drugs in long term therapies, and may also be useful in assuring safe withdrawal when the patient is weaned off of the steroids.

Skin benefits
The anti-inflammatory properties of licorice root are also useful when topically applied. Licorice tea, salve, or oil infusion can be used to relieve the uncomfortable symptoms of various skin disorders, such as psoriasis, eczema, contact dermatitis, and flea-bite allergies.

Liver benefits
In addition to its powerful anti-inflammatory actions, licorice root is also useful in the treatment and prevention of many forms of liver disease. Over the past two decades, medical researchers in China and Japan have found (through animal studies) that extracts of licorice root are useful in the treatment of chronic and chemically induced hepatitis, and that the herb has liver-protectant qualities that are no less significant than those offered by the popular liver herb, milk thistle (Silybum marianum).

However, the mechanisms by which licorice root works in the liver are quite different from those of milk thistle. While milk thistle has been shown to resist liver cell destruction largely through protection of the cell walls and by antioxidant actions, licorice works through a broader diversity of effects.

In addition to a protectant action that glycyrrhizin has upon the liver cells, licorice also enhances interferon and T-cell production, two natural actions that are critical to liver repair and general resistance to disease.

In Chinese medicine, licorice is commonly used as a “liver detoxifier” in the treatment of obstructive jaundice. And in several studies licorice has been shown to benefit animals who are suffering from liver damage due to absorbed or ingested toxins, such as carbon tetrachloride.

Immune system benefits
In a very recent study, the root of Glycyrrhizza uralensis (an Asian species of licorice) was found to have a potentiating effect on the reticuloendothelial system; the body’s first line of defense against infection. In essence, the reticulo-endothelial system is comprised of specialized cells whose jobs are to seek out and eliminate invading microbes and dead blood cells, and licorice helps to stimulate these little bloodstream warriors into action.

Using licorice
Like all herbal medicines, a major problem with the use of licorice in animals is getting it into them, or keeping it on them. Here licorice affords us another comfort; it’s naturally sweet! In fact the sweet flavor of licorice is often used to mask the unpleasant flavor of other herbs.

The next time you give your dog an herb she hates, try adding a small percentage of low-alcohol licorice root extract (say 5 - 10 percent) to the total volume of the dose. You may find that the sweet flavor makes the administration experience more pleasant for both of you, and even if the “taste test” fails, you have potentiated your other herbs with the healing benefits of licorice!



Contraindications
Like all herbal medicines, the primary rule is moderation and insight when using licorice. Most herbalists and practitioners will agree that the risks of adverse side effects from licorice are limited to those who recklessly abuse it.

I have never seen a case of licorice-induced toxicity – but if used in very large, highly concentrated doses (especially over long periods of time), it is conceivable that corticosteroid-like side effects could occur, including water retention, hypertension, and loss of potassium, sodium retention and other symptoms of adrenal hyperactivity. In human studies, the large majority of these side effects have been observed following the excessive consumption of European licorice candy, which is made from a very concentrated, pressed extract of the root. (Most licorice candy produced in America contains absolutely no real licorice, but instead an artificial flavoring or the extracts of other plants that taste similar). Nevertheless, licorice should not be used with reckless abandon.

Animals with pre-existing cardiovascular conditions should not be given licorice without professional guidance.

References

1. Madisch A, Holtmann G, Mayr G, et al. Treatment of functional dyspepsia with a herbal preparation. A double-blind, randomized, placebo-controlled, multicenter trial. Digestion. 2004;69(1):45-52.
2. Gupta VK, Fatima A, Faridi U, et al. Antimicrobial potential of Glycyrrhiza glabra roots. J Ethnopharmacol. Mar 5 2008;116(2):377-380.
3. Jo EH, Hong HD, Ahn NC, et al. Modulations of the Bcl-2/Bax family were involved in the chemopreventive effects of licorice root (Glycyrrhiza uralensis Fisch) in MCF-7 human breast cancer cell. J Agric Food Chem. Mar 24 2004;52(6):1715-1719.
4. Takahashi T, Takasuka N, Iigo M, et al. Isoliquiritigenin, a flavonoid from licorice, reduces prostaglandin E2 and nitric oxide, causes apoptosis, and suppresses aberrant crypt foci development. Cancer Sci. May 2004;95(5):448-453..
5. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. 1st ed. London: Pharmaceutical Press; 1996.
6. Blumenthal M, Goldberg A, Brinckmann J, et al. Herbal Medicine, Expanded Commission E Monographs. Austin: American Botanical Council; 2000.
7. Tyler V. Herbs of Choice, the Therapeutical Use of Phytomedicinals. Binghamton: Pharmaceutical Press; 1994.
8. Miyamura M, Ono M, Kyotani S, et al. [Properties of glycyrrhizin in Kampo extracts including licorice root and changes in the blood concentration of glycyrrhetic acid after oral administration of Kampo extracts]. Yakugaku Zasshi. Mar 1996;116(3):209-216.
9. Badr AE, Omar N, Badria FA. A laboratory evaluation of the antibacterial and cytotoxic effect of Liquorice when used as root canal medicament. Int Endod J. 2010 Aug 31.
10. Kim YH, Shin EK, Kim DH, et al. Antiangiogenic effect of licochalcone A. Biochem Pharmacol.2010 Oct 15;80(8):1152-9.
11. Park SY, Lim SS, Kim JK, et al. Hexane-ethanol extract of Glycyrrhiza uralensis containing licoricidin inhibits the metastatic capacity of DU145 human prostate cancer cells. Br J Nutr. 2010 May 21:1-11.
12. Chandrasekaran CV, Deepak HB, Thiyagarajan P, et al. Dual inhibitory effect of Glycyrrhiza glabra (GutGard™) on COX and LOX products. Phytomedicine. 2010 Sep 21.
13. Gol'dberg ED, Amosova EN, Zueva EP, et al. Licorice preparations improve efficiency of chemotherapy and surgical treatment of transplanted tumors. Bull Exp Biol Med. 2008 Feb;145(2):252-5.

Lucy takes 1 Swanson Licorice Root capsule

Dog Cancer and Pain Medications

One of the most important tenets of holistic medicine is managing pain in  cancer patients.  All cancers cause inflammation which leads to chronic pain ranging from mild to severe.  Regardless of whether conventional or alternative modalities are employed, all cancer patients must be treated for pain.  I firmly believe this is the time and place when pharmaceuticals should be employed.  Numerous studies have shown the earlier these drugs are used, the better the patient will do.  This is true of people and animal patients—PAIN MUST BE TREATED EARLY! NSAIDS, or non-steroidal anti-inflammatory drugs, are utilized first to combat pain and inflammation. These are prescription drugs ( such as Rimadyl, Deramaxx, or Metacam(Meloxicam)) pets take daily in pill or liquid form on a long term basis.  If NSAIDS are not controlling  pain well enough,  then analgesics, such as gabapentin and amantadine, are  added to the pain treatment protocol.  Both of these analgesics  work on neurological receptors to control maladaptive pain.  They have been extensively used to help people battle chronic pain and are showing much promise for our animal friends as well. Tramadol, a synthetic opioid, can be used for acute flare-up of pain or break-through pain.



I will be writing more about alternative pain medications for dogs who cannot tolerate NSAIDs in the near future, but there are times when an NSAID really is the best choice for pain control. This might be because other types of pain medication don't fully control the pain, or because the animal is sensitive to other medications as well.


There are things you can do to make NSAIDs easier on the dog's GI tract, although they will not always be enough for every dog. To understand how some of these might work, it's important to understand what NSAIDs are, and how they function to control pain.


NSAIDs are anti-inflammatory drugs that inhibit an enzyme called cyclooxygenase (COX for short). Cyclooxygenase is a substance in the body that causes it to produce prostaglandins, which cause pain and swelling. The problem is, prostaglandins do all sorts of beneficial things in the body, too, like maintain and repair the intestinal lining, control the body's hormonal systems, and regulate kidney function. There are, in fact, few body systems that do not rely, at least in part, on prostaglandins, so inhibiting them clearly has the potential to cause as many problems as it solves, or more.


Most people know that non-steroidal anti-inflammatory drugs (NSAIDs) such as Rimadyl, Metacam/Meloxicam, Previcox, Deramaxx, Etogesic, and others can irritate the digestive system and cause ulcers of the GI tract. They do this because COX enzymes and prostaglandins are necessary to repair and maintain the intestinal lining. In fact, while kidney damage and death do occur as a result of these drugs and get most of the hype, the main reason dogs are removed from NSAID therapy is because of the damage to their GI tract, including nausea, vomiting, diarrhea, ulcers, and bloody stool.


There are different kinds of COX, and they serve slightly different functions. It was once believed that COX-2 was the "bad" COX, and COX-1 was the "good" COX, and so the newer generation NSAIDs have been developed to be more and more COX-2 specific, but that is not turning out to be the case. It seems that COX-2 does have a protective effect on the gastrointestinal lining, and older generation NSAIDs like aspirin, which tend to inhibit COX-1 more so, or equally to, COX-2, actually have some GI-protectant benefits that help make up for the damage they cause.


So, if your dog has osteoarthritis or some other form of chronic pain, and really needs to take NSAIDs to maintain quality of life, there are a number of things you can do to prevent gastrointestinal problems.


First, make sure you are using multi-modal pain control. If you aren't relying exclusively on the NSAID for total pain control, you'll be able to use a lower dose, or even skip a day every few days and give the gut a chance to heal. Drugs such as Tramadol, amantadine, gabapentin, and narcotics can be used in combination with NSAIDs, or instead of NSAIDs, to control the pain of cancer or osteoarthritis. If your veterinarian isn't familiar with these drugs or is unsure of how to use them, ask for a referral to, or ask your vet to consult with, a veterinary anesthesiologist, or with the Analgesia/Anesthesia consultants on the Veterinary Information Network if they are a member. There is also a great deal of valuable veterinary information on the website of the Veterinary Anesthesia Support Group.


Second, consider alternatives to be used in combination with, or instead of, NSAIDs. Fish oil capsules, glucosamine-chondroiton, Adequan injections, and acupuncture are among the main available alternative therapies that have shown benefit in many cases of osteoarthritis and inflammation. (And of course, keep your dog lean!)


Third, ask your veterinarian about misoprostol. Misoprostol is a prostaglandin analog, and by taking it orally along with NSAIDs, you can help mitigate some of the effect of COX inhibition on the intestinal lining. While misoprostol can cause upset stomach and diarrhea on its own in some dogs, if your dog tolerates it, it's well worth considering as an adjunct to NSAIDs.


Another useful drug is Sucralfate. 
Stomach ulceration in humans is a prominent medical condition and there has long been pressure to develop effective and convenient ways to address this problem. Until relatively recently, we relied on simply neutralizing stomach acid by pouring alkaline solutions (i.e., Alka Seltzer, Tums, Rolaids etc.) into the stomach. In fact, ulceration is a complicate process and there are many ways to address it.

Sucralfate was developed as an adjunctive treatment for stomach ulcers in humans.  Sucralfate is a sucrose aluminum hydroxide compound that forms a gel-like webbing over ulcerated or eroded tissues thus serving as a sort of a bandage. It is effective in the upper GI tract: stomach, duodenum (upper small intestine), and esophagus.

Sucralfate not only “bandages” the ulcer but accumulates healing tissue factors in its bandage; it not only protects the ulcer but actively assists in the healing process. Because Sucralfate is a locally acting medication and is not absorbed into the body it has very limited side effects potential.

How about antacids like Pepcid (famotidine) and acid controllers like Prilosec (omeprazole)? While they might reduce the symptoms of GI ulcers in dogs on NSAIDs, they don't appear to have any benefit at all in actually reducing the ulcers once they occurred. So despite their widespread use with NSAIDs, they may actually mask an ongoing problem. Misoprostol actually has some acid regulating properties itself, but more than that, it acts to restore the intestinal lining naturally, to prevent the formation of ulcers and help heal those that have already formed. In addition, the use of antacids can be contraindicated with both misoprostol and sucralfate.


The herb slippery elm might also be worth considering, although it's not clear if it actually helps heal the gut, simply provides some protection to the intestinal lining, or only serves to make the dog feel better. Slippery elm, the inner bark of ulmus fulva, is a soothing, gelatinous substance that has traditionally been used for the treatment of ulcers. It is also used for sore throats and skin irritations. Slippery elm is an extremely safe herb and is actually used as a food. It is sold in bulk in health food stores, as well as in capsules and as a tincture. It's slightly sweet so most dogs will eat it readily, but it can be given in capsule form or as a tincture if necessary. A veterinary product exists called Phytomucil.


Of course, the side effects of NSAIDs are not limited to the GI tract, so it's important to work with your veterinarian to monitor your pet's kidney and liver function as well.