Tag Archives: Endocrine Disorders

A Herald of Diabetes

The young woman who walked in for a consultation had a scarf wound around her neck. “I came to show you this,” she said, taking it off. There was a dark patch on the back of her neck with ridges and bumps, the skin raised and velvety. “I have already tried fairness creams,” she said. “They only make it worse.”
The diagnosis was easy. She had a peculiar skin lesion known as acanthosis nigricans.

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The cosmetically disfiguring and aesthetically displeasing lesions usually occur on the neck (where they are clearly visible), armpit, groin, knees or elbows, in short areas with skin folds. Very rarely, it can be found on the fingers or around the lips or in the nipple area. It can occur at any age and in both men and women. It is seen in children and even in babies. The lesions appear gradually and do not itch or pain. This means that they remain unnoticed until they have spread over a large area. Initially it looks like dirt so people try to scrub it off, damaging the skin in the process. Others try to camouflage it unsuccessfully with talcum powder and make up.

Nearly 20 per cent of the population has acanthosis nigricans and the numbers are rising rapidly because obesity is the commonest risk factor. More and more people are becoming overweight in India and the world.

An inactive lifestyle causes weight gain and these two factors together cause relative insulin resistance, which results in elevated glucose levels, an abnormal lipid profile and high blood pressure. These changes are grouped together as the “metabolic syndrome X”. Acanthosis nigricans is one of the early markers of this syndrome. The American diabetic association classified it as a risk factor for the development of diabetes in 2000. In children and adolescents, symptoms of syndrome X or frank diabetes begin to appear within two years of the appearance of acanthosis nigricans.

The disease can also be hereditary and in typical inherited acanthosis nigricans, skin lesions are confined to one half of the body. They spread and increase till a certain age and then remain stationery or regress. In other families the lesions, though present in almost all family members, are not really hereditary. The biggest difference is that they are present on both sides of the body. The family usually has an inactive lifestyle, members are obese and go on to develop diabetes.

Medications can also cause these skin changes as a side effect. The most common offenders are hormones — like oral contraceptive pills (OCP), hormone replacement therapy (HRT), insulin, pituitary extract, growth hormone or systemic corticosteroids. Unfortunately, pituitary extract or steroids may be added to unregulated “natural herbal supplements” or “tonics” so the person may not even know that he or she is ingesting such substances. Sulpha drugs (antibiotic)and nicotinic acid (for high cholesterol) can also cause these.

Certain types of acanthosis nigricans are peculiar to women. It is associated with the polycystic ovary syndrome and appears at adolescence. Such girls are obese and have irregular periods and facial hair.

If you develop acanthosis nigricans, it is worthwhile consulting a physician. Although you may be obese, and that is the commonest cause of these skin changes, some investigations and tests need to be done. This is because the skin changes can (though this is rare) be associated with cancer, particularly in the abdomen. It can appear before any other obvious sign of a tumour. It can also be a part of the spectrum of autoimmune diseases like systemic lupus erythematosus, scleroderma, Sjögren syndrome, or Hashimoto thyroiditis.

There really is no specific treatment for the skin changes in acanthosis nigricans. The disease itself is harmless. The main danger lies in the complications associated with obesity and insulin resistance. Tackling the underlying problem makes the skin lesions fade. Here is what you can do to tackle it:

• If it is due to medication or health supplements, stop taking them.

• Reduce your weight with diet and exercise. Try to reach your ideal body weight (height in meter squared multiplied by 23).

• Eat more protein, fresh fruits and vegetables. Starches and sugars provide empty calories and aggravate insulin resistance.

• Sweat trapped in the folds can make the lesions malodorous. Bathe twice a day with a medicated soap like Neko if that is the case.

Evening primrose oil or fish oil supplements may help.

• Some prescription creams or lotions help lighten the affected areas. These contain modified vitamin A products and are often prescribed for acne.

• Fairness creams do not help.

• Surgical dermal abrasion can be done.

Source:  The Telegraph ( Kolkata, India)



Gymnema silvestre

Botanical Name : Gymnema silvestre

Family: Asclepiadaceae
Genus: Gymnema
Species: G. sylvestre
Kingdom: Plantae
Order: Gentianales

Common Name :Gurmari, Gurmarbooti, Gurmar, periploca of the woods, meshasring.

Alternative names:
Despite the part used being the leaf, one common name of this species is miracle fruit, a name shared by two other species: Synsepalum dulcificum and Thaumatococcus daniellii. Both species are used to alter the perceived sweetness of foods.

In English the species is also known as gymnema, Cowplant and Australian cowplant.

This species also goes under many other names such as; Gurmari, Gurmarbooti, Gurmar, periploca of the woods and Meshasringa. The Hindi word Gur-mar (Madhunaashini in Sanskrit, Chakkarakolli in Malayalam,Podapatri in Telugu), literally means sugar destroyer. Meshasringa (Sanskrit) translates as “ram’s horn”, a name given to the plant from the shape of its fruits. Gymnema derives from the Greek words “gymnos”  and “n?ma” (????) meaning “naked” and “thread” respectively, the species epitheton sylvestre means “of the forest” in Latin.

Habitat :  Gymnema silvestre is   native to the tropical forests of southern and central India where it has been used as a natural treatment for diabetes for nearly two millennia.

Gudmar or Gymnema Sylvestre is Large climbers, rooting at nodes, leaves elliptic, acuminate, base acute to acuminate, glabrous above sparsely or densely tomentose beneath; Flowers small, in axillary and lateral umbel like cymes, pedicels long; Calyx-lobes long, ovate, obtuse, pubescent; Corolla pale yellow campanulate, valvate, corona single, with 5 fleshy scales. Scales adnate to throat of corolla tube between lobes; Anther connective produced into a membranous tip, pollinia 2, erect, carpels 2,unilocular; locules many ovuled; Follicle long, fusiform1.

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Chemical composition:
The major bioactive constituents of Gymnema sylvestris are a group of oleanane type triterpenoid saponins known as gymnemic acids. The latter contain several acylated (tigloyl, methylbutyroyl etc.,) derivatives of deacylgymnemic acid (DAGA) which is 3-O-glucuronide of gymnemagenin (3, 16, 21, 22, 23, 28-hexahydroxy-olean-12-ene)2. The individual gymnemic acids (saponins) include gymnemic acids I-VII, gymnemosides A-F, gymnemasaponins.

G. sylvestre leaves contain triterpene saponins belonging to oleanane and dammarene classes. Oleanane saponins are gymnemic acids and gymnemasaponins, while dammarene saponins are gymnemasides. Besides this, other plant constituents are flavones, anthraquinones, hentri-acontane, pentatriacontane, ? and ?- chlorophylls, phytin, resins, d-quercitol, tartaric acid, formic acid, butyric acid, lupeol, ?-amyrin related glycosides and stigmasterol. The plant extract also tests positive for alkaloids. Leaves of this species yield acidic glycosides and anthroquinones and their derivatives.

Gymnemic acids have antidiabetic, antisweetener and anti-inflammatory activities. The antidiabetic array of molecules has been identified as a group of closely related gymnemic acids after it was successfully isolated and purified from the leaves of Gymnema sylvestre. Later, the phytoconstituents of Gymnema sylvestre were isolated, and their chemistry and structures were studied and elucidated.

Medicinal Uses:
While it is still being studied, and the effects of the herb are not entirely known, the herb has been shown to reduce blood sugar levels when used for an extended period of time. Additionally, Gymnema reduces the taste of sugar when it is placed in the mouth, thus some use it to fight sugar cravings. From extract of the leaves were isolated glycosides known as Gymnemic acids, which exhibit anti-sweet activity.

This effect lasts up to about 2 hours. Some postulate that the herb actually reduces cravings for sugar by blocking sugar receptors in the tongue. This effect was observed in rats in a 2003 study conducted by CH Lemon, et al. It is currently being used in an all natural medication for diabetes with other ingredients such as cinnamon, chromium, zinc, biotin, banaba plant, huckleberry and bitter melon.

The active ingredients are thought to be the family of compounds related to gymnemic acid: purified gymnemic acids are widely used as experimental reagents in taste physiology and have also been shown to affect experimental diabetes, reduce intestinal transport of sugars. and fatty acids. Extracts of Gymnema is not only claimed to curb sweet tooths but also for treatment of as varied problems as hyperglycemia, obesity, high cholesterol levels, anemia and digestion. The leaves were also used for stomach ailments, constipation, water retention, and liver disease; historically these claims are not supported by scientific studies.[8] According to the Sushruta of the Ayurveda it helps to treat Madhumeha ie glycosuria.[citation needed]

In 2005, a study made by King’s College, London, United Kingdom, showed that a water-soluble extract of Gymnema Sylvestre, caused reversible increases in intracellular calcium and insulin secretion in mouse and human ?-cells when used at a concentration (0.125 mg/ml) without compromising cell viability. Hence forth these data suggest that extracts derived from Gymnema Sylvestre may be useful as therapeutic agents for the stimulation of insulin secretion in individuals with Type 2 Diabetes.[9] According to research done by Persaud and colleagues in 1999 the raise in insulin levels may be due to regeneration of the cells in the pancreas.  Gymnema can also help prevent adrenal hormones from stimulating the liver to produce glucose, thereby reducing blood sugar levels  Clinical trials with diabetics in India have used 400 mg per day of water-soluble acidic fraction of the gymnema leaves. However, Gymnema cannot be used in place of insulin to control blood sugar by people with either Type 1 or Type 2 Diabetes.

In 2010, King’s College, London, United Kingdom performed another study on Gymnema Sylvestre. OmSantal Adivasi extract, a high molecular weight extract from the plant Gymnema Sylvestre was found to improve the symptoms of type 2 diabetes mellitus. Glycemic control after OmSantal Adivasi administration was related to increased circulating levels of insulin and/or C-peptide. Experimenting with human islets in vitro, there was a rapid onset response to OmSantal Adivasi exposure, continued for extent of exposure to OmSantal Adivasi, and also a rapid reverse if there was a withdrawal of OmSantal Adivasi. OmSantal Adivasi created a biphasic pattern of glucose-induced insulin secretion. This resulted in enhanced rates of insulin secretion being maintained for length of exposure to OmSantal Adivasi. Other Gymnema Sylvestre extracts induce cell damage to the membrane causing pathological and unregulated release of insulin to BETA-cells. OmSantal Adivasi has a low concentration of saponin, what causes damage to cell membranes, which would be degraded during digestion. OmSantal Adivasi directly stimulates BETA-cells of the islets of Langerhans, reducing fasting and post-prandial blood glucose. OmSantal Adivasi experiments, in vitro, initiated insulin secretion at a sub-stimulatory concentration of glucose. OmSantal Adivasi has been shown to effectively reduce blood glucose and increase plasma insulin and C-peptide levels in humans

Indian physicians first used Gymnema to treat diabetes over 2,000 years ago.  . In the 1920s, preliminary scientific studies found some evidence that Gymnema leaves can reduce blood sugar levels, but nothing much came of this observation for decades.  It is a taste suppressant.  By topical application gymnema has been shown to block the sweet and some of the bitter taste, but not salt and acid taste.  By keeping off the sweet taste it helps to control a craving for sugar.  Responsible for this are considered saponins.  Gymnema has also shown mild hypoglycemic effect.  Topically (applied to the tongue, mainly to the tip or by chewing) it is used to control a craving for sugar, recommended as an aid to a weightloss diet and diabetes.  Internally it is used as an adjuvant (tea, h.p.) for diabetes. Gymnema leaves raise insulin levels, according to research in healthy volunteers. Based on animal studies, this may be due to regeneration of the cells in the pancreas that secrete insulin. Other animal research shows that Gymnema can also improve uptake of glucose into cells and prevent adrenaline from stimulating the liver to produce glucose, thereby reducing blood sugar levels. The leaves are also noted for lowering serum cholesterol and triglycerides.  In the past, powdered Gymnema root was used to treat snake bites, constipation, stomach complaints, water retention, and liver disease.

Gurmar, also known as Gymnema or Gymnema Sylvestre, is often referred to as “sugar destroyer” and has been used in Ayurveda since the 6th century BC. It has been used in Ayurvedic medicine for several centuries as a safe and natural approach to help regulate sugar metabolism. The key component of Gymnema – Gymnemic Acids – mimics glucose molecules, numbing receptor sites on the tongue. Gymnema contains Gymnemic acid, Quercitol, Lupeol, Beta-Amyrin and Stigmasterol, all of which are thought to help the body maintain healthy blood glucose levels.

Benefits of Gymnema Sylvestre (Gurmar)
Gymnema may:

*Help abolish the taste of sugar*
*Help manage sugar cravings and sugar addictions*
*Help support healthy glucose metabolism*
*Help maintain healthy blood sugar levels*
*Support healthy weight*

The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider.



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Pheochromocytomas are a type of tumor of the adrenal glands that can release high levels of epinephrine and norepinephrine. As the name implies, the “ad-renal” glands are located near the “renal” area. In other words, the adrenal glands are small glands that are located near the top of the kidneys. One adrenal gland sits on top of each of the two kidneys.

Despite their small size, the adrenal glands have many functions. They are complex endocrine (hormone secreting) glands. Cells in different regions of the adrenal glands have different functions in the endocrine system. There is an area (zona fasciculata) where the cells secrete cortisol, a hormone similar to cortisone. There is another area (zona glomerulosa) where cells secrete a hormone called aldosterone which helps in water regulation.


There is yet another area, referred to as the adrenal medulla, where the cells secrete substances called catecholamines — epinephrine, norepinephrine and dopamine. These are “flight or fight” hormones. They are responsible in part for that feeling of an “adrenaline” rush people feel when they are afraid. It is these cells that are involved in a pheochromocytoma. Basically, a pheochromocytoma is a tumor of these catecholamine-secreting cells, and that causes the clinical signs and symptoms we will discuss below. The catecholamine-secreting cells are sometimes referred to as chromaffin cells, and they are found in other areas of the body as well as in the adrenal medulla.

Sometimes, pheochromocytomas arise from chromaffin cells that are located outside of the adrenal gland. In this case, they are termed extra-adrenal pheochromocytomas or paragangliomas and are usually located in the abdomen.

Pheochromocytomas may occur in persons of any age. The peak incidence is between the third and the fifth decades of life, but approximately 10% occur in children. Pheochromocytomas are, fortunately, quite rare (only about 800 new cases are diagnosed per year in the US) and the majority of them are entirely benign. Only about 10% of pheochromocytomas are malignant.

Signs and symptoms:
The signs and symptoms of a pheochromocytoma are those of sympathetic nervous system hyperactivity, including:

*Skin sensations
*Flank pain
*Elevated heart rate
*Elevated blood pressure, including paroxysmal (sporadic, episodic) high blood pressure, which sometimes can be more difficult to detect; another clue to the presence of pheochromocytoma is orthostatic hypotension (a fall in systolic blood pressure greater than 20 mmHg or a fall in diastolic blood pressure greater than 10 mmHg upon standing)

*Anxiety often resembling that of a panic attack
*Diaphoresis (excessive sweating)
*Weight loss
*Localized amyloid deposits found microscopically
*Elevated blood glucose level (due primarily to catecholamine stimulation of lipolysis (breakdown of stored fat) leading to high levels of free fatty acids and the subsequent inhibition of glucose uptake by muscle cells. Further, stimulation of beta-adrenergic receptors leads to glycogenolysis and gluconeogenesis and thus elevation of blood glucose levels).

A pheochromocytoma can also cause resistant arterial hypertension. A pheochromocytoma can be fatal if it causes malignant hypertension, or severely high blood pressure. This hypertension is not well controlled with standard blood pressure medications.

Not all patients experience all of the signs and symptoms listed. The most common presentation is headache, excessive sweating, and increased heart rate, with the attack subsiding in less than one hour.

Tumors may grow very large, but most are smaller than 10 cm.

Conditions that are associated with Pheochromocytomas can be a component of certain familial or genetic syndromes. The most common familial condition is called multiple endocrine neoplasia, or MEN for short. Two types of MEN — MEN 2A and 2B — are associated with pheochromocytomas. Both are genetic syndromes that run in families and are transmitted from parent to child in an autosomal dominant manner.

Pheochromocytomas are not the only tumors that occur in MEN 2A and 2B. MEN 2A carries an increased risk of tumors of the parathyroids, glands near the thyroid that help to regulate calcium levels in the body. And both MEN 2A and 2B elevate the risk of thyroid cancer. In families where MEN is suspected, genetic testing can be done to help identify family members at risk.

Pheochromocytomas are a feature of other genetic disorders, including von Hippel-Lindau syndrome and neurofibromatosis. Both of these disorders are associated with the development of numerous benign and malignant tumors.

There are also many individuals who have pheochromocytomas with no known family history of them. These cases are termed sporadic. In general, if these patients have bilateral disease (pheochromocytomas in both adrenal glands) or are diagnosed before the age of 21, genetic screening is recommended.

*About 10% of adrenal cases are bilateral (suggesting hereditary disease)
*About 10% of adrenal cases occur in children (also suggesting hereditary disease)
*About 15% are extra-adrenal (located in any orthosympathetic tissue): of these 9% are in the abdomen and 1% are located elsewhere. Some extra-adrenal pheochromocytomas are probably actually paragangliomas, but the distinction is only possible after surgical resection.

*About 11.1% of adrenal cases are malignant, but this rises to 30% for extra-adrenal cases
*About 26% are hereditary (earlier opinion had 10%)
*About 3% recur after being resected
*About 14% of affected individuals do not have arterial hypertension (Campbell’s Urology)

Other Causes:
Basically, anything that can cause over activity of the sympathetic nervous system can be on the list of diagnoses to rule out when suspecting a pheochromocytoma. The sympathetic system is the main control panel governing the release of the “flight or fight” response in response to stress or fear, as mentioned above. Things that can stimulate this include drugs (even excessive use of decongestants should be considered); withdrawal from drugs (such as suddenly stopping certain blood pressure medications); panic attacks, and spinal cord injuries are among the many conditions that can also lead to some of the symptoms seen in pheochromocytomas.

Up to 25% of pheochromocytomas may be familial. Mutations of the genes VHL, RET, NF1(Gene 17 Neurofibromatosis type 1), SDHB and SDHD are all known to cause familial pheochromocytoma/extra-adrenal paraganglioma.

Pheochromocytoma is a tumor of the multiple endocrine neoplasia syndrome, type IIA and type IIB (also known as MEN IIA and MEN IIB, respectively). The other component neoplasms of that syndrome include parathyroid adenomas, and medullary thyroid cancer. Mutations in the autosomal RET proto-oncogene drives these malignancies . Common mutations in the RET oncogene may also account for medullary sponge kidney as well.

Pheochromocytoma linked to MEN II can be caused by RET oncogene mutations. Both syndromes are characterized by pheochromocytoma as well as thyroid cancer (thyroid medullary carcinoma). MEN IIA also presents with hyperparathyroidism, while MEN IIB also presents with mucosal neuroma. It is now postulated that Lincoln suffered from MEN IIB, rather than Marfan’s syndrome as previously thought, though this is uncertain.

Pheochromocytoma is also associated with neurofibromatosis.

The diagnosis can be established by measuring catecholamines and metanephrines in plasma (blood) or through a 24-hour urine collection. Care should be taken to rule out other causes of adrenergic (adrenalin-like) excess like hypoglycemia, stress, exercise, and drugs affecting the catecholamines like stimulants, methyldopa, dopamine agonists, or ganglion blocking antihypertensives. Various foodstuffs (e.g. vanilla ice cream) can also affect the levels of urinary metanephrine and VMA (vanillylmandelic acid). Imaging by computed tomography or a T2 weighted MRI of the head, neck, and chest, and abdomen can help localize the tumor. Tumors can also be located using an MIBG scan, which is scintigraphy using iodine-123-marked metaiodobenzylguanidine.

Pheochromocytomas occur most often during young-adult to mid-adult life.

These tumors can form a pattern with other endocrine gland cancers which is labeled multiple endocrine neoplasia (MEN). Pheochromocytoma may occur in patients with MEN 2 and MEN 3 (MEN 2B). Von Hippel Lindau patients may also develop these tumors.

Patients experiencing symptoms associated with pheochromocytoma should be aware that it is rare. However, it often goes undiagnosed until autopsy; therefore patients might wisely choose to take steps to provide a physician with important clues, such as recording whether blood pressure changes significantly during episodes of apparent anxiety.

*Blood Tests: analysis of free metanephrine in blood plasma. High levels are indicative of pheochromocytoma

*Urine Tests: Although this test is slightly less effective than plasma testing it is still considered highly effective in diagnosis. Usually the metabolites of norepinephrine and epinephrine, vanillylmandelic acid (VMA) and homovanillic acid (HVA) are found in relatively small amounts in normal humans. The increased intermittent excretion of these metabolites is indicative of the disease, but does not completely rule out other diseases which may cause the same excretion values.


*Other Tests:
….#One diagnostic test used in the past for a pheochromocytoma is to administer clonidine, a centrally-acting alpha-2 agonist used to treat high blood pressure. Clonidine mimics catecholamines in the brain, causing it to reduce the activity of the sympathetic nerves controlling the adrenal medulla. A healthy adrenal medulla will respond to the clonidine suppression test by reducing catecholamine production; the lack of a response is evidence of pheochromocytoma.

….#Chromogranin A is elevated in case of pheochromocytoma.

….#Another test is for the clinician to press gently on the adrenal gland. A pheochromocytoma will often release a burst of catecholamines, with the associated signs and symptoms quickly following. This method is NOT recommended because of possible complications arising from a potentially massive release of catecholamines.

.#Warning: Testing via histamine and tyramine is dangerous and should not be used.


Tumor location:
In adults, approximately 80% of pheochromocytomas are unilateral and solitary, 10% are bilateral, and 10% are extra-adrenal. In children, a fourth of tumors are bilateral, and an additional fourth are extra-adrenal. Solitary lesions inexplicably favor the right side. Although pheochromocytomas may grow to large size (>3 kg), most weigh <100 g and are <10 cm in diameter. Pheochromocytomas are highly vascular.

The tumors are made up of large, polyhedral, pleomorphic chromaffin cells. Fewer than 10% of these are malignant. As with several other endocrine tumors, malignancy cannot be determined from the histologic appearance; tumors that contain large number of aneuploid or tetraploid cells, as determined by flow cytometry, are more likely to recur. Local invasion of surrounding tissues or distant metastases indicate malignancy.

Extra-adrenal Pheochromocytomas: Extra-adrenal pheochromocytomas usually weigh 20 to 40 g and are <5 cm in diameter. Most are located within the abdomen in association with the celiac, superior mesenteric, inferior mesenteric ganglia and Organ of Zuckerkandl. Approximately 10% are in the thorax, 1% are within the urinary bladder, and less than 3% are in the neck, usually in association with the sympathetic ganglia or the extracranial branches of the ninth cranial nerves....CLICK  & SEE
Differential diagnosis
The differential diagnoses of pheochromocytoma include:

*Anxiety disorders

*Essential hypertension
*Mercury poisoning
*Paroxysmal supraventricular tachycardia
*Renovascular hypertension

Treatment and recovery
Treatment involves drugs to bring blood pressure to normal levels, followed by surgery to remove the tumour. Blood pressure and adrenaline/noradrenaline levels must be checked for some time afterwards to ensure that removal of the tumour was complete. If the tumour was benign then survival rates are high, but in people affected by malignant pheochromocytomas, less than 50 per cent survive longer than five years.

Since the cause of phaeochromocytoma is unknown, it isn’t possible to prevent it.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose


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Botanical Name :Lagerstroemia speciosa Linn.
Family: Lythraceae
Genus: Lagerstroemia
Species: L. speciosa
Kingdom: Plantae
Division: Magnoliophyta
Class: Magnoliopsida
Order: Myrtales

Other scientific Names:Munchausia speciosa Linn.,Lagestroemia reginae Roxb.,Lagerstroemia flos-reginae Retz.

Common Names: Agaro (Sbl.),Mitla (Pamp.), Bugarom (S. L. Bis.),Nabulong (Neg.),Banaba (Tag.), Pamalauagon (S. L. Bis.),Duguam (S. KL. Bis.)  Pamarauagon (S. L. Bis.),Kauilan (P. Bis.) Parasabukung (Sub.),Makablos (Pang,Tabangau (Ibn., Neg.),Tauagnau (Ibn.),Pride of India (Engl.) ,Queen’s flower (Engl.)

Habitat: Banaba is  native to tropical southern Asia.Grows wild; widely distributed in the Philippines, in the secondary forests at low and medium altitudes. Cultivated for its beautiful flowers. Propagation by seeds.

A decidious tropical flowering tree, 5 to 10 m high, sometimes growing to a height of 20 meters. Leaves, large, spatulate, oblong to elliptic-ovate, 2-4 inches in width, 5-8 inches in length; shedding its leaves the first months of the year. Before shedding, the leaves are bright orange or red during which time it is thought to contain higher levels of corosolic acid). Flowers are racemes, pink to lavender; flowering from March to June. After flowering, the tree bears large clumps of oval nutlike fruit…..click & see

Click to see the pictures


It is grown in South East Asia, India and the Philippines.It is also widely cultivated as an ornamental plant in tropical and subtropical areas.

Chemical constituents:
Rich in tannin: fruit, 14 to 17 %; leaves 13 %; bark, 10%.
• Studies have isolated: (1) corosolic acid (2) ellagitannin Lagerstroemin (3) gallotannins
• Penta-O-galloyl-glucopyranose (PPG) – identified as the most potent of the gallotannins, with a higher glucose transport stimulatory activity than Lagerstroemin. In addition to stimulating glucose uptake in fat cells, it also has anti-adipogenic properties.

Medicinal Uses:

Parts utilized:  Leaves, fruits, flowers and bark.

Banaba extract is used as a natural health supplement and is made from the leaves of the banaba tree. Some research suggests that banaba extract may support blood sugar balance and weight loss. The primary active ingredient is corosolic acid, and there are also numerous possible synergists including lager-stroemin, flosin B and reginin A.

* Roots have been used for a variety of stomach ailments. Leaf decoction for diabetes; also use as a diuretic and purgative.
* Decoction of old leaves and dried fruit (dried from one to two weeks), 50 gms to a pint of boiling water, 4 to 6 cups daily has been used for diabetes. Old leaves and ripe fruit are preferred, believed to have greater glucose lowering effect. Young leaves and flowers have a similar effect, though only 70% that of matures leaves and fruits. The wood has no known glucose lowering effect; the bark, a very small amount. A decoction of 20 gms of old leaves or dried fruit in 100 cc of water was found to have the equivalent effect to that of 6 to 7.7 units of insulin.
* The bark decoction has been used for the treatment of diarrhea.
* The bark, flowers and leaves used to facilitiate bowel movements.
* Decoction of fruits or roots gargled for aphthous stomatitis.
* Decoction of leaves and flowers used for fevers and as diuretic.
* Leaf decoction or infusion used for bladder and kidney inflammation, dysuria, and other urinary dysfunctions.

*Banaba Tea The leaves of the Banaba and other parts are used widely by the Philippines, Taiwan, and Japan as a Tea preparation. This tea is consumed as a natural means for a variety of reasons involving the kidneys, such as dissolving kidney stones, kidney cleanses, and kidney health in general. Research being conducted in Japan shows much promise for this plant and its potential uses in the medical community.


• Corosolic Acid / Lagerstroemin / Gallotannins: Studies have identified several compounds as responsible for its anti-diabetic activity. (1) corosolic acid (2) Lagerstroemin, an ellagitannin (3) gallotannins, of which PPG – penta-O-galloyl-glucopyranose–was identified as the most potent, with a higher glucose transport stimulatory activity than Lagerstroemin. In addition to stimulating glucose uptake in fat cells, it also has anti-adipogenic properties.
• Inhibition of TNF-induced Activation: Diabetes leads to cardiomyocyte hypertrophy in association with upregulation of vasoactive factors and activation of nuclear factor (NF)-kappaB and activating protein-1. Study results indicate L speciosa can inhibit DNA-binding of NF-kappaB which may explain its possible inhibition of diabetes-induced cardiomyocyte hypertrophy.
Ellagitannins / Insulin-like Glucose Uptake Stimulatory/Inhibitory Activities / Adipocyte Differentiation-Inhibitory Activity: Study yielded seven ellagitannins, including lagerstroemin from the leaves of L speciosa. The ellagitannins exhibited strong activities in both stimulating insulin-like glucose uptake and inhibiting adipocyte differentiation . Also, ellagic acid derivatives showed inhibitory effect on glucose trasport.
• Diabetes: (1) Banaba has been extensively studied for its application in the treatment of diabetes. Early on, Its ability to lower blood sugar was attributed to corosolic acid, a triterpenoid glycoside, belived to facilitate glucose-transport into cells. (2) Studied with abutra, akapulko, makabuhay for antidiabetic activity through activation of gucose transporter activity. One of the active principles from Banaba was the tripertene, corosolic aicd.
• Weight loss: Studies in mice suggest an antiobesity effect. It is becoming a common ingredient in weight-loss supplements / products as a metabolic enhancer.
• Hypertension: It is also being studied for its use in the treatment of blood pressure, renal and immune system benefits.
• Lipid-lowering: Studies in mice suggest a lipid lowering effect – decreasing triglyceride and total cholesterol levels. To date, no toxicity has been identified.
Hypoglycemic Activity of Irradiated Banaba Leaves: Study showed the effects of nBLE and iBLE were comparable to the hypoglycemic effects of insulin.
• Xanthine oxidase inhibitors from the leaves of Lagerstroemia speciosa (L.) Pers: Xanthine oxidase is a key enzyme involved with hyperuricemia, catalyzing the oxidation of hypoxanthine to xanthine to uric aicd. The study supports the dietary use of the aqueous extracts from Banaba leaves for the prevention and treatment of hyperuricemia.
• Antidiabetic Activity: Study showed a significant reduction of blood glucose levels with the soft gel formulation showing better bioavailability than a dry-powder formulation.
• Other studies report potential uses: (1) antibacterial effects from seed extracts (2) significant protection of HIV-infected cells by ellagic acid constituents (3) antioxidative activity of a water extract (4) inhibition of xanthine oxidase by aqueous extract, 31 and anti-inflammatory activity in mice.
Anti-Inflammatory / Free Radical Scavenging: Study showed antioxidant and anti-inflammatory activities from the ethyl acetate and ethanol extracts of Lagerstroemia speciosa.

The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider.


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Asteracantha longifolia Nees (Bengali Name : Kuliakhara)

Botanical Name : Asteracantha longifolia Nees

Family: Acanthaceae
Genus: Astercantha
Species: A. longifolia
Kingdom: Plantae
Order: Lamiales
Syn. / Hygrophila spinosa T. Anders. /Asteracantha longifolia (Linn.) Nees. (Acanthaceae).
English Name : Hygrophila
Sanskrit Names : Kokilaksha, Ikshura, Ikshuraka, Chulli
Hindi Name:Talimakhana
Bengali Name : Kuliakhara

Habitat : It grows throughout India.Throughout the Philippines in stagnant streams, fresh-water swamps, and  ponds.

It is a robust, erect, annual herb. The stems are sub-quadrangular with thickened nodes; the leaves are oblanceolate, with a yellow spine in its axil; the flowers pale, purple blue, densely clustered in  axils; the fruits are oblong, glabrous capsules, 4-8 seeded.
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A smooth, widely spreading vine, with the stems trailing on mud or floating on water. Leaves are oblong-ovatem 7-14 cm long, with a pointed tip and heart- or arrow-shaped base, long petioled, the margins entire or angular, and sublobed.
The pedcuncles are erect, 2.5 to 5 cm long, with 1 or 2 flowers in the axils of the leaves. Sepals are green, oblong, about 8 mm. The corolla is narrowly bell-shaped, about 5 mm long, and purplish with the tube deeper purple inside.

Principal Constituents:
The seeds contain large amount of tenacious mucilage and potassium salts.

Medicinal Uses:
The roots, leaves and seeds have been used in Indian systems of medicine as diuretics and also employed to cure jaundice, dropsy, rheumatism, anasarca and diseases of the urinogenital tract.
The plant contains abundant mucilage and potassium salts, which ultimately increases blood circulation in the body. The whole plant possesses tonic and diuretic properties. The seeds are given for gonorrhoea. The root, in decoction, is administered in dropsical cases and gravel; The leaves are also used as a diuretic after being boiled in vinegar. The ashes of the dried plants are considered

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Kuliakhara herb Asteracantha longifolia plant for liver health and sexual enhancement :
Revista Brasileira de Farmacognosia  :
Asteracantha longifolia plant health benefit  :

Tops are mildly laxative.
The purplish variety used for diabetes because of assumed insulin-like principle it contains.
Juice used as emetic.
Dried latex is purgative.
Poultice of buds used for ringworm.
In Ayurveda, exgtracts of leaves are used for jaundice and nervous debility.
Juice used as emetic in opium and arsenic poisoning.
In Sri Lanka, used for liver disease, eye problems, constipation.

Studies :
• Hypoglycemic / Anti-Diabetic: (1) Study showed the boiled whole extract of I. aquatica to exert an oral hypoglycemic effect in healthy, male, Wistar rats after a glucose challenge. (2) An aqueous extract of the green leafy vegetable Ipomoea aquatica is as effective as the oral hypoglycaemic drug tolbutamide in reducing the blood sugar levels of Wistar rats.(3) Inhibitory effect of Ipomoea aquatica extracts on glucose absorption using a perfused rat intestinal preparation: Study showed a significant inhibitory effect on glucose absorption. Furthermore, results suggest the inhibition of glucose absorption is not due to the acceleration of intestinal transit. (3) Study showed the consumption of shredded, fresh, edible portion of IA for one week, effectively reduced the fasting blood sugar of Streptozotocin-induced diabetic rats.

• Antioxidant / Antiproliferative: Antioxidant and antiproliferative activities of water spinach (Ipomoea aquatica Forsk) constituents: Study showed the water extract of stems had the highest antiproliferative activity. The ethanol extract of the stems had the highest total phenolic compounds. The ethanol extract of leafves had the highest amount of flavonoids.

Diuretic: Study on the diuretic activity of the methanol extract of Ipomoea aquatica in Swiss albino mice showed good diuretic activty. In all cases, the excretion of electrolytes and urine volue increase was higher than the standard diuretic, furosemide.

• Antioxidant: Study of a methanol extract yielded a compound ( 7-O-B-D-glucopyronosyl-dihydromquercetin-3-O-a-D-glucopyranoside) that exhibited antioxidant activity with an EC50 value of 83 and showed very strong lipid peroxidation-inhibitory activirty in a liposome model system.

• Antimicrobial: Study investigating the antimicrobial efficacy of the leaf extract of three herbs – A longifolia, I aquatica and E fluctuans – on four pathogenic bacterial strains (E coli, P aeruginosa, S aureus and M luteus). Ipomoea aquatica exerted the higher amount of antimicrobial activity against the bacterial strains, better than the two other herb extracts.

• Antiulcerogenic: Study in an aspirin-induced ulcer model in rats found Ipomoea aquatica to possess potent anti-ulcerogenic and ulcer-healing properties and can act as a potent therapeutic agent against peptic ulcer disease.

• Cytotoxicity: Study isolated a purified bioactive compound from the leaf of Ipomoea aquatica – 7-O-B-D-glucopyranosyl-dihydroquercetin-3-O-a-D-glucopyranoside (DHQG). Results showed DHQG showed cytotoxicity towards cancer cell lines tested.

• Nootropic / Memory Enhancing Potential: Study suggests that MEIA markedly improves brain Ach level. MEIA treatment may be of value in reinforcing depressed cholinergic transmission in certain age related memory disorders and to improve memory and learning in normal individuals.

The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider.



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