Chasteberry Snapshot Monograph

Transcription

1 herbs Chasteberry Snapshot Monograph Chasteberry (Vitex agnuscastus) Most Frequent Reported Uses: - Helps balance pituitary function. - Helps balance sex hormonal levels for men and women. - Reported progesterone like effects. - Used in insufficient lactation and hyperprolactenemia. - Used for breast discomfort after childbirth. Herb Name: Chasteberry, Chaste tree, Chaste tree berry, Vitex (Vitex agnus-castus) fruit Introduction: The chaste tree originated in the Mediterranean but is now found worldwide as an ornamental shrub. Its fruit is harvested and dried for medicinal purposes. It has a long folk history of use in women s health. The berry of the chaste tree has been recommended for use in mild to moderate complaints, especially in endometriosis, menopause, and PMS symptoms. Functions: Orally, chasteberry is used for menstrual irregularities including dysmenorrhea, secondary amenorrhea, metrorrhagia, oligomenorrhea, and polymenorrhea (He et al, 2009; Doll et al, 2009). Chasteberry is also used for symptoms of menopause, for symptoms of premenstrual syndrome (PMS) including cyclical mastalgia, luteal-phase dysfunction (corpus luteum insufficiency), and other symptoms. It is also used orally for treating female infertility, preventing miscarriage in patients with progesterone insufficiency, controlling postpartum bleeding, aiding in expulsion of the placenta,

2 increasing lactation, and treating fibrocystic breasts. It is used for promoting urination, treating benign prostatic hyperplasia (BPH), and reducing sexual desire. Chasteberry is also used for acne. The actual activity of the constituents of chasteberry is not fully established at this time. Studies have reported it to have significant effect on the pituitary (Jarry et al, 1994). Studies point to a progesterone-like component and effect. Studies report that vitex stimulates luteinizing hormone (LH) and inhibits follicle stimulating hormone (FSH). Because of this activity, vitex has been recommended for a variety of female complaints, such as PMS, amenorrhea, menopausal symptoms, endometriosis, and hyperprolactinemia. Several studies have reported beneficial effects of vitex on femalerelated disorders (Loch et al, 2009; Propping et al, 1991). Several clinical studies have reported beneficial results with using chasteberry in treating women with infertility associated with corpus luteum deficiency. A multicentric non-interventional trial (open study without control) was conducted to study the efficacy and tolerance of chasteberry extract in 1634 patients suffering PMS (Berger et al, 2000). Four major symptoms of PMS were monitored, including depression, anxiety, craving and hyperhydration. After a treatment period of three menstrual cycles, 93% of patients reported a decrease in the number of symptoms or even cessation of PMS complaints. Mastodynia was still present after 3 months of therapy but were generally less severe than before treatment. A combination of chasteberry and St. John s wort (Hypericum perforatum) was found in a double-blind, randomized, placebo-controlled parallel trial to be superior to placebo for total PMS-like scores including anxiety (van Die et al, 2009). Chasteberry may also be of benefit in acne, as human data reports increasing healing while using a chasteberry preparation. Due to dopaminergic activity, it has been postulated that chasteberry may be used in the management of Parkinson s disease, although no clinical research has been performed to support that theory. Dosage:* mg every morning, preferably on an empty stomach, either 1 hour before or 2 hours after breakfast, standardized to contain at least 0.5% agnuside and 0.6% aucubin; OR 4mg daily standardized to 6% agnuside. *Note: There are various products with different dosages and standardizations to choose from. When choosing a dietary supplement, select those from reputable manufacturers. Side Effects and Warnings: Chasteberry has been reported to be safe in recommended doses. Do not use in pregnancy. Laboratory studies report emmenagogue and uterine stimulant activity.

3 Do not use chasteberry supplements if trying to use contraception to prevent pregnancy. Chasteberry may inhibit FSH and increase LH, causing progesterone to rise and lengthening the luteal phase. A clinical study in China reported that an extract of vitex prolonged menstrual period in some patients (Ma et al, Gynaecol Endocrinol 2010). Chasteberry supplements should only be used under the supervision of a practitioner if hormonally related cancers, such as breast, prostate or uterine, is a concern. Caution should be use if taking the following medications with chasteberry: Based on pharmacology, use with caution with dopamine agonists such as haloperidol, metoclopramide or levodopa.

4 Chasteberry (Vitex agnus-castus) Patient Snapshot Uses: Chasteberry may help support healthy hormone levels in both men and women. Chasteberry is reported to help balance progesterone levels. Healthy progesterone levels are associated with improved mood, decreased anxiety, improved bone health and may decrease the risk of developing breast cancer. Dosage:* The most common dose of chasteberry is mg every morning, preferably on an empty stomach, either 1 hour before or 2 hours after breakfast, standardized to contain at least 0.5% agnuside and 0.6% aucubin; OR 4mg daily standardized to 6% agnuside. *Note: There are various products with different dosages and standardizations to choose from. When choosing a dietary supplement, select those from reputable manufacturers. Talk to your doctor of pharmacist. Special Concerns: If you are taking prescription or non-prescription medications or have a pre-existing medical condition, talk with your healthcare provider before taking any dietary supplement. Do not take if there is an allergy to any component of this dietary supplement. Do not use in pregnancy. Do not use if using or taking contraception. Individuals on any of the following medications should only take chasteberry under a doctor's supervision: o Dopamine agonists including haloperidol (Haldol), metoclopramide (Reglan) or levodopa (Sinemet). o Those with concern for hormonally related cancers, such as breast, uterine or prostate. DISCLAIMER: Statements made are for educational purposes and have not been evaluated by the US Food and Drug Administration. They are not intended to diagnose, treat, cure, or prevent any disease. If you have a medical condition or disease, please talk to your doctor prior to using the recommendations given.

5 References: Atmaca M, Kumru S, Tezcan E. Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder. Hum Psychopharmacol 2003;18(3): Berger D, Schaffner W, Schrader E, et al. Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre- menstrual syndrome (PMS). Arch Gynecol Obstet 2000;264(3): Daniele C, Thompson Coon J, Pittler MH, Ernst E. Vitex agnus castus: a systematic review of adverse events. Drug Saf. 2005;28(4): Dittmar FW. Premenstrual syndrome: treatment with a phytopharmaceutical [in German]. TW Gynakologie 1992;5(1): Döll M. [The premenstrual syndrome: effectiveness of Vitex agnus castus] Med Monatsschr Pharm May;32(5): Dugoua JJ, Seely D, Perri D, Koren G, Mills E. Safety and efficacy of chastetree (Vitex agnus-castus) during pregnancy and lactation. Can J Clin Pharmacol Winter;15(1):e74-9. Epub 2008 Jan 18. Review. Gregl A. Klinik und therapie der mastodynie. Med Welt 1985;36: Halaska M, Raus K, Beles P, et al. [Treatment of cyclical mastodynia using an extract of Vitex agnus castus: results of a double-blind comparison with a placebo]. Ceska Gynekol 1998;63(5): He Z, Chen R, Zhou Y, Geng L, Zhang Z, Chen S, Yao Y, Lu J, Lin S. Treatment for premenstrual syndrome with Vitex agnus castus: A prospective, randomized, multi-center placebo controlled study in China. Maturitas May 20;63(1): Jarry H, Leonhardt S, Gorkow C, et al. In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus: direct evidence for a dopaminergic principle by the dopamine receptor assay. Exp Clin Endocrinol 1994;102(6): Jarry H, Leonhardt S, Wuttke W, et al. [Agnus castus as a dopaminergic active constituent in Mastodynon N]. Zeitschrift fur Phytotherapie 1991;12: Jarry H, Spengler B, Porzel A, et al. Evidence for Estrogen Receptor beta-selective Activity of Vitex agnus-castus and Isolated Flavones. Planta Med 2003;69(10): Lauritzen C, Reuter HD, Repges R, et al. Treatment of premenstrual tension syndrome with Vitex angus castus: Controlled, double-blind study versus pyridoxine. Phytomedicine 1997;4(3): Loch EG, Selle H, Boblitz N. Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. J Womens Health Gend Based Med 2000;9(3): Ma L, Lin S, Chen R, et a. Treatment of moderate to severe premenstrual syndrome with Vitex agnus castus in Chinese women. Gynaecol and Endocrinol. 2010;26: Merz PG, Gorkow C, Schrodter A, et al. The effects of a special Agnus castus extract (BP1095E1) on prolactin secretion in healthy male subjects. Exp Clin Endocrinol Diabetes 1996;104(6):

6 Peters-Welte C, Albrecht M. [Menstrual abnormalities and PMS. Vitex agnus-castus in a study of application]. Therapiewoche Gynakologie 1994;7(1): Propping D. Vitex agnus-castus: treatment of gynecological syndromes. [in German]. Therapeutikon 1991;5: Roemheld-Hamm B. Chasteberry. Am Fam Physician. 2005;72(5): Prilepskaya VN, Ledina AV, Tagiyeva AV, Revazova FS. Vitex agnus castus: Successful treatment of moderate to severe premenstrual syndrome. Maturitas. 2006;55 Suppl 1:S Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ 2001;322(7279): Sliutz G, Speiser P, Schultz AM, et al. Agnus castus extracts inhibit prolactin secretion of rat pituitary cells. Horm Metab Res 1993;25(5): van Die MD, Bone KM, Burger HG, Reece JE, Teede HJ. Effects of a combination of Hypericum perforatum and Vitex agnus-castus on PMS-like symptoms in late-perimenopausal women: findings from a subpopulation analysis. J Altern Complement Med Sep;15(9): Wuttke W, Jarry H, Christoffel V, et al. Chaste tree (Vitex agnus-castus)--pharmacology and clinical indications. Phytomedicine 2003;10(4): DISCLAIMER: Statements made are for educational purposes and have not been evaluated by the US Food and Drug Administration. They are not intended to diagnose, treat, cure, or prevent any disease. If you have a medical condition or disease, please talk to your doctor prior to using the recommendations given.