Harnessing Hepatics: Marion Mackonochie's on Herbs for Liver Health

Episode 23 • 14th March 2024 • Herbcast • Herbal Reality

Sebastian: Hello there.

Sebastian: Welcome to the herbcast, the podcast from herbal reality, delving into the plant powered world of herbalism. So, do you know your echinacea from your erythrococcus, or your polyphenol from your polysaccharides? Whether you're a budding herbalist, an inquisitive health professional, or a botanical beginner, herbcast is here to inform and inspire you on your journey to integrating herbs in our everyday lives. So, settle down, turn us up, and let's start today's episode of the herbal reality Herbcast.

Sebastian: I'm here with Marion Mackonochie and, um, I've had the pleasure of working with Marion over the last few years, because Marion's a great herbalist and is a member of the College of Phytotherapeutic Practitioners, and has been senior herbal advisor at Pucker for many years. And you do lots of other things, don't you? Also, don't you edit the journal of Herbal Medicine and you're on the herbal History Research Network?

Marion: I am indeed, yes. And then participant in the herbal alliance as well.

Sebastian: In this series of herbcasts. We're wanting to talk about herbal actions and the categories of herbs, really. How do we group plants together in terms of what they do, and want to talk a bit about, um, what conditions they're best for, perhaps some of their research, phytochemistry, maybe some energetics and history, if we can creep that in, any sustainability issues. So it's really looking at these categories of herbs. And I'm very excited today to be talking to you, Marianne, because, um, we're going to talk about the liver and herbs for the liver and the hepatics, that category of herbs and such an important feature of health and healing. And so maybe we should just dive in and you tell us a bit about the liver and some of the symptoms that you might see in your clinic, really? And then we'll go on to talk about some of the herbs that can help.

Marion: Yeah, great. I mean, it was a really exciting topic. I was quite pleased when you reached out, uh, and proposed it, um, because it's the heart of all herbalism, really, isn't it? Uh, always considering the liver, um, with pretty much every prescription, I think it's the powerhouse of the body, responsible for metabolizing pretty much anything that we put into the body, processing everything responsible for carbohydrate metabolism, uh, uh, so energy, making sure the body's functioning. Yeah, uh, everything. So I guess sort of signs that it's not working very well. Uh, uh, congestion, uh, and a, uh, lack of being able to get rid of other things. So lots, um, of skin conditions. I think, uh, I would be thinking about the liver. And then also, um, for women, hormonal issues, massive connection with the liver, because obviously, all the hormones in the body are also processed by the liver. So if it's not doing its job very well or is a bit overburdened, then you get a build up of a, uh, build up of hormones or their metabolites, and that can lead to things like, um, fibroids and endometriosis, sort of, uh, oestrogen dominant conditions. So, yeah, I think probably hormonal stuff, tend to treat more. I've not had anyone with actual liver disease, as it were, but, um, obviously the liver, you touch on the liver with most stuff and lots of digestive things. If you can get the liver working well, then the rest of the digestion follows. Um, I think I was also quite interested in the connection between bitter and liver, because we think of most liver herbs as being bitters, don't we? And I was wondering if that was. Is that always the case? Um, does it have to be that, and is that the way they're generally having their effect? So, yeah, I had a little bit of a deep dive. I don't know what your thoughts are on that one.

Sebastian: No, I don't think all herbs that are good for the liver have to be bitter, per se, but there definitely seems to be a preponderance of bitter herbs that are good for the liver, obviously because of the bitter impulse. Um, but I think some of them can be blander. I don't know. Like, milk thistle is quite a bland, m tasting herb to a degree, and something like rosemary isn't necessarily immediately bitter in my mind, but it's very good for it. So I was interested what you said there, just going back a little bit, how you said you think you treat nearly every person that comes into your clinic with herbs for the liver, but actually you've never seen a liver disease, per se. I don't know, hepatitis, should we say, or jaundice, more serious infections or whatever. So I thought that was fascinating. And I think that sums up a lot about herbal medicine. Maybe you'd elaborate a bit on that, because this idea that you're treating the person and what you see and the patterns, but it might not be, uh, a clinically defined disease in the liver, but we still use those herbs for those hormones, digestion, etcetera, you're saying.

Marion: Yeah, well, I mean, quite often we see, people who, um, have been to their doctor and, um, they're not feeling great, they're not particularly well. But there's no kind of often no serious clinical disease that's being diagnosed. And the doctors have said, well, you just feel a bit rubbish. Sorry, off you go. So we do see a lot of people like that, where their body's just not functioning at its best. But you can really make a difference to quality of life by improving, nudging the body, making these organs work, uh, in their most optimum way, I think.

Sebastian: Well, I like what you said there about helping the body work at its best and nudging it in the right direction. And I think I often associate liver issues with a general malaise and sluggishness. Like, I know I've got this sort of heavy chinese and ayurvedic background, but I always sort of see it as a sort of seat of stagnation, in a way, and blockage and leading to dampness and puffiness and, um, just system not working properly, basically. Um, in terms of stagnating your mood, your flow of your feelings. Of course, there's a sort of physiological facts related with that. Um, but it's this stuckness is how I see so much liver. And that in initiating a treatment, when you go and see a herbalist, often we'll talk about what the herbs are, how they work as such. But often those prescriptions help, um, open the gate, if you like, and help the free flow of. Whether you look at it from a vitalistic life force point of view, or you look at it from a point of view of getting the flow of a bile and the metabolism of hormones and metabolic wastes more effective. Um, I think the result is the same. Uh, you get a greater sense of vitality, um, that reenters the body and its own, um, healing mechanisms get initiated.

Marion: Yeah, well, there is a traditional link between liver, the liver and mood, isn't there? And a connection between depression, low mood. There's the whole idea of the galenic cholertic sort of personality or constitution, um, which would be the liverish person who sort of wasn't producing enough bile and needed increasing production of bile.

Sebastian: Well, we use it in our language, don't we? Someone's feeling a bit bilious if they're a bit moody or, uh, liverish, uh, or feeling a bit green under the gills. Um, yeah, just what you were saying there about the bitters. Um, and obviously, most people you see in clinic have got some type of digestive issue. And the immediate benefits you have there. There's been some interesting research and science coming out about bitters, hasn't there? Because there was this theory. Is it almost a herb and myth that you needed to taste the bitters for it to have an effect? And so all these poor suffering clients have been chucking down these bitter herbs.

Marion: Um, beautifully tasting andrographis.

Sebastian: Yeah, exactly. Share a bit about how you use bitters. And some of this new research maybe on the broadening.

Marion: I think we know that if you taste some bitters, you immediately notice it, don't you? You get the kind of, um, saliva increasing in your mouth, and you know that it's starting a digestive process, but yet sort of research is showing now that we have bitter receptors the entire way through the gut, not just in the mouth. So you absolutely don't necessarily need to be tasting that bitter. I mean, I think it helps because you are then starting the digestive process from the mouth rather than further down or wherever the bitter would hit, uh, the receptors, but then the whole way through and on things like immune cells as well. Um, and there was lots of connections during the pandemic made between, um, bitters and immune functioning. And links were made between, um, people who were super tasters of bitters and whether they were more likely to get serious Covid or not. For example, research. Um, and it's pretty complex, and I don't think anyone's managed to untangle exactly what's going on there. But, um, they're definitely doing some pretty universal things throughout the body that aren't necessarily just related to digestion, for example, which is how we would see them.

Sebastian: But I'd thought and read, I'm sure in the past that people that have got less sensitivity to bitter, uh, taste and flavor have got higher, um, issues of mortality or health issues because often associated with obesity or, um, these sorts of blockage system, uh, problems. So I'm interested in hearing that it was the other way around in some of the COVID ways, people thinking if you were a supertaster. Because some people are super tasters of bitter, aren't they? Where you have this very, um, sort of refined perception of small levels of bitter notes. Um, yeah, that's interesting. It seems that quite a lot of herbs that were classified as bitters have now become renowned for their immunological function, haven't they? So that's interesting to explore.

Marion: Yeah, well, andrographis is a prime example of that, isn't it? I would absolutely think of it foremost, uh, as an immune supporting, um, herb. But obviously king of the bitters. Uh, bitter is definitely one of its, um, primary qualities. And in terms of ayurveda, which sort of conditions or qualities would you link it to? Primarily?

Sebastian: Yeah, well, that's andrographis peniculata. We're talking about one of the bitterest, uh, herbs, a small, shrubby, bushy plant. Um, I've had always associated with, uh, treating pitter conditions and higher levels of inflammation. There's this sort of saying. Dr. Ad had always said, uh, bitter is better for pitter. So pitter being the quality of health that, uh, relates to redness, heat, inflammation, often liver pathologies. So andrographis used for hepatitis, acute or chronic liver problems. Um, also used for the liver and eye association in traditional medicine, andrographis would be used for various eye infections as well. Um, but, uh, apart from acute infections, digestive problems, it's very good for, um, intestinal sort of dysbiosis, if you'd want to call it that. And, uh, any sign of inflammation or even, uh, proliferation of protozoa and things like that in the digestive tract. So, yeah, andrographis, one of the great herbs. I mean, there's other herbs as well, other immunological herbs. I mean, like golden seal. It's got a past as a bitter, but it's got this sort of immunological function, hasn't it?

Marion: Yeah, absolutely. Um, I guess lots of it's the berberines, which is the kind of livery bitter bits. And there's lots of other herbs which contain those, um, cheledonium, which we spoke about before.

Sebastian: Yeah. I mean, another thing to talk about is the grade of bitters, I think, in terms of the strength of herbs. And you've got entry level bitters, perhaps, like, would you say chamomile or something like that? Um, maybe even minister a little bit or some fennel or something like that. Got slight notes of bitterness, haven't they? Um, and then you're in the. Where are we in the middle range. Where would we go? Is it dandelion?

Marion: Yeah. I actually got out my tinctures this morning and did a little bitter taste test with all of them. Licorice came out.

Sebastian: Ah.

Marion: I would say that's in the middle of the bitter, bitter range. Um, I guess partly because the sweetness of it and the pungent flavor sort of overpowers the bitter a little bit.

Sebastian: Maybe peel, isn't it, as well, you can get peeled licorice. The peel is quite bitter in it.

Marion: Yeah. Yarrow I'd put in the middle there with reasonable bitterness. Yeah, I didn't get much. Maybe it's a reflection of the tincture I've got at the moment. But I didn't get much bitter from my turmeric tincture. Um, and I tried some shazandra, um, which is one of my favorites. And that wasn't particularly bitter, um, even though it's meant to be five flavors.

Sebastian: Yeah, it's interesting. Two of the herbs most renowned for regenerating the liver, as I'm aware, shizandra and milk thistle. They aren't very bitter, but they're not. They've got evidence of regenerating hepatocytes, haven't they? So they do help regenerate the liver. So this idea of it just being bitters is, uh, obviously slightly misplaced. But they've got this powerful position there, um, and then going up into the higher realm where you would want to be much more cautious about dose because there are issues about using these, uh, hepatics with conditions in the liver, with gallstones or wherever. There's sort of constriction or activity in the bile ducts.

Marion: Gentian wormwood, those would be up there, I reckon.

Sebastian: Yeah.

Marion: I mean, I use that in very low doses. Gentian. It's a bit brutal, isn't?

Sebastian: Is? It is. And we mentioned a couple of gentian and know they've both got very serious sustainability issues that need attention to where you're sourcing those from. And like you say, they're very good herbs to use at a low dose because they're so precious commodities as such and take so long to grow. And their environment's been challenged. Um, but they do have very specific clinical indications, don't they? And so they've obviously got very broad use. There's something interesting as well about the bitters is that there's quite a few different receptors, aren't there? 30 or so bitter receptors and, uh, different bitter compounds in herbs meet those different receptors or match together with those different receptors. So it's that sort of interesting validation for synergy in herbal medicine. Uh, that when you blend together different bitter herbs, you actually reach more of those receptors. And so there is a positive case for us mixing. I think Kerry Bowen talks about mixing gentian and maybe evafus and probably wormwood, uh, together to reach a broad range of receptors. But it probably works. Um, that principle works across any sort of magisterial prescription.

Marion: Yeah, I think he had hops in there as well. Fever, few hops. And genshin perhaps were the ones all. Yeah. Yes. There's an interesting presentation that one m um. I also like the connection of um. I've found bitters more recently helpful for people who are quite anxious. And obviously you've got a herb like vervain which is a sort of typical nervous system tonic that's also bitter and can be used for sort of digestive upsets and things like that. But um. Um. I've had a couple of highly anxious patients who've responded really well to just putting a tiny amount of say five mil of gentian into their mix just to have that bitter grounding I guess. Um. Um. And that's worked really well and I don't know whether that's just putting you more into parasympathetic rest and relax mode um and taking people out of flight and fight. Um. Or if there's something more going on perhaps with this idea of liver being the seat of mood and things being helped out there. Interesting.

Sebastian: Energetically bitters are cooling and opening and um can be grounding as well at the right dose. So um. There's definitely something to be said for that. They obviously shift stagnation and stuckness in people. So if there is a depression or low mood from an indigestible experience which so many are in life then it does seem to be very valuable and helping. Not that it can remove that pain or suffering but it can help you digest it is how I sort of see it translate in reality as people can work through that uh uh, difficulty and come to terms with it really. Because lots of depression is things we. Because of things we can't control. In a way we're frustrated with those things. But it helps you accept.

Marion: That's a nice way of looking at it.

Sebastian: Generalization there. But um. Um. Yeah I think that energetics uh helps and there's something about bitter making life taste better. There's that sort of irony that uh bitters taste rubbish. We don't like them. We've outbread them out of our vegetables. Food used to be a lot more bitter really didn't it? And uh. Apparently and um um. It seems that if you include a little bit of it in your life it tastes sweeter.

Marion: Without bread. Bitter from vegetables. But um. People love coffee, right? And that's a really bitter thing. It's really popular. And often some of these bitter receptor sort of studies showed that people um who were super tasters of bitters quite often really liked coffee. So even though they perhaps wouldn't necessarily like bitters in other capacities they really liked this intense coffee bitter hit. And I guess bitters once upon a time were a, uh, safety thing. Lots of bitter things are quite toxic. And so it would have been, um, an evolutionary adaptation. Taste a bitter thing and be really cautious of it and try and avoid it. But then we've kind of learned to.

Sebastian: Love some of these bitters and maybe guidance that these are potent plants that should be used at low doses. Normally, traditionally in herbal medicine, bitters, apart from an acute thing, you would always use at a lower dose, possibly even for a shorter time, isn't it? Rather than sweeter tonics that you might take for some months at a time or longer, bitters tend to be used at a smaller dose for a shorter period of time. Um, because they are so strong, aren't they? I mean, it just, uh, has an immediate effect. I mean, there's quite a few modern day major issues going on with our health system that seem that they would benefit from bitters. I mean, diabetes, cholesterol, obviously, further, uh, blood sugar regulation. Maybe that's worth exploring because it seems like with public health epidemic going on in those areas, and I know you've done a lot of research into spices and the benefit of foods that people could include in their daily diet that aren't, um, necessarily herbal medicines per se at that dose, but that could enhance that sort of public's health. Maybe we could explore a bit of that around some of those major issues we're facing as a society.

Marion: Yeah, absolutely. I mean, there's a lot of clinical evidence for even as low as culinary doses of herbs and spices that you could use for things like, uh, reducing cholesterol levels or, um, supporting healthy blood sugar control, whether that's via sort of insulin sensitivity or keeping a blood glucose level really stable, uh, reducing things like inflammatory markers in the blood. And yet some of the most promising-looking culinary herbs and spices are things like turmeric, obviously. Um, ginger, cinnamon, garlic, fenugreek is particularly good. And, uh, one of the interesting ones I came across when I was doing this research was cardamom. And, uh, how much evidence there is for it in reducing inflammatory markers in the body, which isn't really something I'd contemplated or considered. And I know it's quite a strong flavor. You've got to be really careful about putting too much by having too much. It's a bit soapy, isn't it? Um, but yeah, there's sort of a lot of evidence that if people were increasing their daily intake of herbs and spices by just sprinkling some, ah, in their dishes every meal, we could be really sort of supporting, um, some of these problems with metabolic syndrome. And as you're saying, diabetes.

Sebastian: You were saying that at food doses, so what, at like a few hundred milligrams, whatever, a quarter of a teaspoon, half a teaspoon level of some of these herbs, they've got clinical evidence showing that they can reduce higher cholesterol or, uh, blood sugar levels.

Marion: Yeah. Because a lot of research using herbs uses either really sort of standardized extracts or really high doses of things. Um, and that's great, and that's fine for some medicinal uses, um, and all well and good, but most people, it's not really accessible for them. It's either really expensive to be daily taking, um, uh, an expensive product, but everyone can add a few sort of grams of herbs and spices. And so, um, the criteria, search criteria that I was using for looking for studies was it had to be just the pure powder. So just either it was cooked into the food. There were quite a few studies that were using. They made chipatis with fenugreek seeds cooked into them, for example, or added this much fresh ginger to the diet. And yet in doses. So I used about 6 grams as a cut off, as a reasonable amount that you wouldn't ruin the flavor of a dish by adding it. Uh, although some of the fenugreek studies used quite high doses, but because they were actually cooking them into the food.

Sebastian: I decided that that quite bit of fenugreek, actually, I've seen these studies like 30 grams or something like that to get, um, lipids down and things. And, uh, yeah, it's pretty nasty, actually. It's quite bitter. I found in my.

Marion: Maybe their participants were lying when they said that they could.

Sebastian: And things like that, and you can get a good dose that way. So some of these things are working via the liver to have these actions, are they? I mean, turmeric is, uh, one of.

Marion: The things I would have thought. Some of them are, yeah, I mean, turmeric definitely has really good effects on blood fats, uh, and has some evidence for, uh, glucose control. And, uh, yeah, I think it probably is working via the liver, certainly fat control. I mean, things are either preventing the absorption of fats, which may be the case for some high fiber things like fenugreek, which is why they were using such high doses, I think. Um, but if they're not, then, ah, either they're preventing absorption or they're impacting how the liver is processing, or, you know, a large part of the cholesterol that we have in our blood is actually produced by the liver. The majority is we don't get a huge amount from our diet. It's a metabolic process that the liver is in control of. So if you can support the liver into not doing too much cholesterol production, then that will work better.

Sebastian: So what's going on, you think? We're just putting it under much more stress delivery these days. That's what it's got more what, pesticides, industrial pollutants, alcohol, chemical drugs, et cetera, to metabolize. Is that what you think the challenges, and also carbohydrates, obviously, sugar, et cetera.

Marion: Yeah, we're abusing it. We're making it much, much harder for it to work all of those things, definitely. Um, and we eat huge amounts of sugar, um, compared to how our ancestors would have eaten. Massive daily doses.

Sebastian: Rise of non alcohol fatty liver disease is, ah, quite concerning. And I think that is something that's definitely coming into the herbal clinics these days as people get diagnosed externally and then it comes in, um, so we can help people, uh, with, uh, the bitter herbs and the hepatics. I always think it's interesting the herbs get put together as a group, because we've talked about lots of these herbs that you could probably put in another category as well, couldn't you? They sort of get put in these homes and you think of milk thistle for the liver or whatever. Or in western herbalism, shusandra wu wei zhe has entered into the sort of hepatic category, but in chinese medicine, it's actually listed as an astringent. Wu wei z uh, and is used for stopping leakage of the shen and the spirit, and is used to hold the sort of grounding and mood in the body, as well as stopping, uh, fluids leaking out of the body and things like that. So it's got sort of totally different categorization, in a way. Um, but because of its effect on phase one and phase two liver enzymes, it's become so popular there, um, and.

Marion: It'S a thing we can measure. Um, yeah, I did a big mind map, and on my mind map I had hepatics in the sensor, and then I had kind of hepatoprotection bitters, um, mood. So kind of as we were talking before, about the bitters being really good for sort of getting into rest and relaxation, and then also lots of blood cleansers. So things like burdock and, um, calendula, um, and red clover, um, lot of those also sit in other bits of this big mind map of things that are connected to hepatics. And then I went on to kind of, um, immunity. So we've got the immunity and inflammations. We've got the andrographis having its impact on inflammation and immunity. And then obviously turmeric liver, but also really good for inflammation. Uh, and uh, there was some evidence of, um, cheladonium being used, uh, in Covid, um, treatment. Um, I think it was kind of lots of case studies, rather than, um, other types of evidence. But that was definitely used during the.

Sebastian: Pandemic for that very strong herb, cheladonium. I don't know, I'm always quite cautious with it. My top grade, obviously is restricted as well to herbalist only. So it was obviously a maximum dose. But, um, yes, it's one of those stronger herbs, isn't it?

Marion: Um, yeah, I don't use it at all. It's not one that's sort of come into, um, my clinic that much, but it grows virulently in my garden, so I feel like the universe is telling me something. Um, I've taken an interest in its effects.

Sebastian: Yeah, those beautiful plants. No, um, doubt. Um, right, so you got this mind map of seeing all these functions that the liver takes, ah, a role in. And you mentioned hormones earlier, and, ah, digestion. You can't really get away without looking after it, can you, in a herbal treatment? It's particularly from a western point, a western sort of herbal approach, because of its central place in physiology. Um, absolutely central.

Marion: Um, yeah, the bitters will stimulate digestion, won't they, in multiple ways, as well as kind of having an impact on bile release and production. Um, also what the pancreas is doing, and then amylase, saliva, all of those things kind of kick start.

Sebastian: And all these receptors are like found in the lungs, uh, in the brain, in the nervous system, as you saying, immune cells. I mean, that's quite remarkable. So, an essential part of everyone's diet. And like you said, you can get it from various herbs and spices. Things like green tea are quite bitter. Um, and then of course, the swedish bitters and that sort of tradition of having a little paratif, uh, before a meal. If you're having a fatty meal, obviously that's one of the great signs of great signs. Clear signs of, uh, liver impairment is inability to digest fats.

Marion: Yeah. Feeling nauseous after fatty foods also came up with brassicas as well. We have to talk about brassicas a little bit, really. I think, I know they're not a herb as such, but they're a bitter food that is really supportive to the liver. Um, uh, there's sulforaphanes.

Sebastian: Yes. We haven't really mentioned this phase one, phase two detoxification, in a way. And I was reading the other day that we're exposed to between two to four kilos a year of pollutants, whether that be through pesticides, et cetera. So that sort of extra burden that's placed on the liver. And, um. Do you use herbs to try and activate those mechanisms or do you not think of it quite like that? It's just that some herbs do phase. Quite happy that they do that job.

Marion: I don't think of it like that, actually. M. When I'm pulling together a, uh, treatment plan, I don't think, oh, this one's doing phase one and this one's doing phase two. I think, um, phase one is all the cytochrome p four and 150 enzymes, isn't it? And there's so much overlap with lots of them. I don't think that's necessarily, uh, a bottleneck, but quite often it's the phase two. I think it's a bit of the bottleneck. And that's where you kind of want other things to support.

Sebastian: Things like Rose, rosemary and Nebraska is particularly good at phase two, isn't it? And this sort of production, um, should we say quickly about cytochrome p 450? I am not an expert on it, so I can't talk about it too much. But quite a few herbs, um, are implicated in their impact on drug metabolism, aren't they? Because many drugs obviously get metabolized through their, uh, notably, uh, hypericum. St. John's war come in for a lot of attention. So what happens there when we take certain herbs, it can upregulate enzymes or impair them.

Marion: They can either be induced or inhibited. Hypericum actually does both to different cytochrome p 450 enzymes. But it's the primary, um, problematic, uh, effect that it has is that it's an activator of one of the cytochrome p 450 enzymes that's, uh, really, uh, often used, um, for metabolizing certain drugs. Um, and so, um, if you activate or induce these enzymes, then they're working over time and they'll clear the medications faster. So if you've got, say, for example, immunosuppressants that someone's on, um, you don't want to give them anything that's going to impact, uh, the levels of immunosuppressants they've got in their body. Something like warfarin, where there's a really narrow therapeutic index. So the amount that you need to, uh, cause toxicity is very close to the amount you need to have any kind of effect. So you don't want to mess around with those. Um, and even things like, um, the contraceptive pill, um, it's been found that that's cleared faster. When people are taking hypericum, obviously you don't want any unwanted pregnancies, so that's one to watch out for. Um, but quite a lot of things will inhibit certain cytochrome p 450 enzymes, and that will prevent the breakdown of things. And then obviously your risk is causing toxicity, um, of any medications people are taking alongside and things like grapefruit, which is why people who are taking warfarin are advised not to drink grapefruit juice because it can mess around with their InR, or their blood clotting levels.

Sebastian: Yeah, I mean, all the more reason to see a herbalist, isn't it, really? Quite honestly, whether that's a good example, because it is a complex area. And whilst we generally see herbs as safe and having a long history of, um, use and used at the right dosage, if you have got issues with hormonal imbalance or your mood or your digestion, whilst you can take some gentle things of chamomile and fennel and peppermint to sort of get things going, any concerns, go and see a professional herbalist, because they'll be able to determine, uh, the patterns and monitor as you progress through the treatment. And also know these things like, about herbs like hypericum, which is a particularly idiosyncratic thing to hypericum, isn't it, that it does this activity on that p 450 pathway, that is not a general, uh, result, uh, of most herbs in any way. And so it is just an idiosyncratic thing that's been found out largely discovered through using super strong extracts and, uh, dosing up the hyperrocin. Um, but I know you're a real expert on research, and there was interesting paper the other day on turmeric and amprazole, and showing that turmeric, uh, can be, uh, as beneficial as a meprazole. Um, I know it's not strictly on the liver, but I imagine you came across it. It was just this idea of digestion, in a way, getting so easily impaired by, should we say, our modern world, antibiotics, stresses modern diet, et cetera. Um, and that amprazole seems to be a highly prescribed drug. It's maybe the drug that most of my patients seem to be on. I don't know, almost. It's very common and it's really problematic and very problematic with nutrient malabsorption, et cetera, et cetera.

Marion: I've seen people with very, very serious b twelve deficiencies that have required injections of b twelve to get them up to. Up to standard again, because they were on long term amepprazole, um, with no advice from the doctor that they should stop it at any point. They've run it for years. Um, and it very effectively stops, um, the discomfort of, uh, reflux, but sort of at a cost. Um, definitely. Um, so, yeah, I saw that with interest. I haven't read the full paper, actually, but I, um, can see why there are many reasons that turmeric would be helpful. Um, part of it is getting the digital. One of the benefits of bitters is getting digestion to work in a more sequential way. So by having bitters, you get the digestion going and get that peristalsis through the gut happening in an ordered way, rather than a disordered way that sends things back up the wrong way. Ah, also the anti inflammatory effect on the gut wall, um, which I'm sure turmeric, a big part of its effect is on the gut wall because we know not a lot of it is actually absorbed. So I think it's having a huge amount of effect on keeping that skin in the gut healthy. Um, and then also the microbiome, which, um, we haven't touched on. But it's huge area of, uh, interesting research going on about, um, improving the microbiome. And we know that the biome within the gut is implicated in things like gastroesophageal reflux disease, because things like having too much h pylori in the stomach is a reflection of that. So we know that there's some disordered m bacterial levels already in lots of gut disease.

Sebastian: Yeah, I mean, it's almost like the plants go into your body. Uh, they're in a direct. They go into a relationship, into a dialogue, having a conversation with your microbiome. And it's this, um. You know, I know that it's early doors in a way, and that it's complex science looking at what is the impact on what. But it does seem like entering into a dialogue that you can, um, with yourself, in a way, with your body, um, whether that's guided by a herbalist or, um, through your diet, you can just really influence your health. It seems like something so empowering that turmeric is on every single shelf. It's like the cheapest, one of the cheapest spices you can get hold of. Um, and how can people access more of this insight and knowledge and knowledge in their lives. And I know you work actively in research looking at how communities might use more herbs and spices and how they can enhance their health. Uh, have we got a few simple tips that would be handy for people? Some of your Marion's magic, some of your favorite. Uh, I know we mentioned some of the herbs, um, but maybe just go through them again, even if we've mentioned them, what are some of the main things you could include daily in your diet?

Marion: Just those herbs and spices. The turmeric we've mentioned, ginger, garlic, fenugreek, if you can cope with this bitterness, cardamom. Um, and then also there's less research, um, on the green herbs, uh, and the sorts of ones that we have in the mediterranean diet, things like oregano and basil, uh, and then thyme and rosemary. Um, there's less evidence out there for them, but we know that they're great. They're really, really high in polyphenol content. Um, and that's going to be part of the reason why lots of these herbs and spices are good for you. They're adding these extra bioactive compounds into your diet that, um, are likely to be why things like the mediterranean diet are so healthy for us. Um, these are the elements that are in fruit and vegetables as well, that sort of help keep you healthy. So, yeah, I think there's the whole, make sure you're increasing the diversity of plant foods in your diet. Um, so lots of fruit and veg, but that also should include herbs and spices as part of that, because they are increasing that diversity. You're consuming much more of these exciting compounds that are likely to be feeding our gut biome, uh, and having all these additional beneficial effects on the body, whether that's through the liver or through the gut wall, or through sort of other, um, effects that we haven't sort of investigated yet.

Sebastian: I know it seems like a ripe era for research. I was surprised finding out how little research there is on thyme and oregano and basil. In a way, some of these more european, um, herbs that we all use so much of. Um, and obviously, looking at some of the research that has been going on, showing why the mediterranean diet is so effective, um, and so many of the great liver herbs that we use come from the great, know, gentian we mentioned, uh, rosemary, milk thistle, all these plants across Europe. Um, so for herbalists, have you got anything to suggest for herbalists regarding the hepatics, um, with regards to dose or safety, or, um, is it just carry on using the great herbs that we have been lucky enough to be trained in.

Marion: Yeah, I think always have a liver herb in your mix, unless there's other things that you really need to put in there. Um, I think that's really important. And it doesn't have to be the super, super bitter ones. Ah, but if you do use those super, super bitter ones, then the advantage is you only use very small amounts and then you got lots of space in your mix for other things, I think. Yeah.

Sebastian: It'S been really great talking with you, Marion. Marion's written, has been a, um, lead author or contributing author in lots and lots of papers. I'd recommend anyone listening to look up, uh, Marion McConaughey's academic, uh, history. And also your website is fieldremedies.com, isn't it? That's where you can be found for your clinical practice. But really, you're a font of knowledge. And, ah, your dedication to research and translating potentially complex theories into practical knowledge about how, uh, scientists and uh, doctors and medics, herbalists can use plants is really, um, a fantastic inspiration, um, to us all, Marion. So thank you, thank you.

Marion: It's been lovely chatting to you, Seb. I've enjoyed myself a lot. I'm generally excited to investigate anything herbal.

Sebastian: Brilliant, Marion, thanks so much.

Marion: Thank you.

Sebastian: You've been listening to the herbcast, the podcast from herbal reality. We hope you enjoyed this episode. If so, perhaps you'd like to leave us a rating that'd really help us to spread our message for herbal health. We hope you'll join us again for the next episode. And in the meantime, if you'd like a few more herbal insights from us, do have a look@herbalreality.com. Or learn more from us via Instagram where we're at herbal reality, and we're on Twitter and Facebook too. We'll be back with another episode of the Herb Car soon. Thanks for joining.

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